在儿童和成年人中吸入雾化上腺素的输送:一个模拟研究
Natalie V Anderson1, William F Ditcham2, Barry Clements3
1School of Population Health, Curtin University, Perth, Australia; Perioperative Medicine Team, The Kids Research Institute Australia, Nedlands, Australia; Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Australia; Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Australia.
在儿童中,吸入上腺素的输送因设备而异. 内分泌管 (ETT) 输送了最多的上腺素,而面罩输送的最少,影响了紧急治疗的有效性.
科学领域:
- 儿科急救医学 儿科急救医学
- 呼吸系统护理 呼吸系统护理
- 药理动力学 药理动力学
背景情况:
- 紧急注射吸入上腺素对于儿科呼吸系统紧急情况,如喘和,至关重要.
- 当前的剂量和管理指南可能无法充分考虑可变的输送效率.
研究的目的:
- 在模拟的儿科环境中,使用不同的接口 (面罩,喉膜呼吸道[LMA],内管[ETT]) 量化通过雾化器传递上腺素.
- 为改善儿童吸入上腺素的紧急剂量和管理指南提供信息.
主要方法:
- 用喷射器或振动网装置模拟儿科体重 (3-75公斤) 的上腺素被雾化.
- 使用面罩,LMA和ETT测量了输送效率,吸入剂量收集在过器上.
- 用液体染色学量化上腺素度.
主要成果:
- 内管 (ETT) 输送的上腺素 (12-32%) 与喉口罩 (LMA) (8-15%) 和面罩 (2-10%) 相比显著更多.
- 在婴儿和幼儿中,LMA分娩大约是面罩分娩的四倍.
- ETT的交付量大约是LMA交付量的两倍.
结论:
- 雾化上腺素的输送效率因儿童使用的呼吸道接口而有很大差异.
- 内分泌管提供了最高的输送,而面罩提供了最低的输送,需要对指南进行审查.
- 需要进一步的研究来优化LMA和面罩的交付,以改善儿科治疗结果.
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