胸部手术中吸入氧气的部分:多少是太多?
Jonathan Gorky1, Andres de Lima, Wanda M Popescu
1Department of Anesthesiology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
在胸部手术期间限制高氧水平可能会改善患者的治疗结果. 在一次肺透气和肺再扩张期间减少吸入氧气 (FiO2) 的部分可以减轻肺损伤风险.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 新出现的证据将麻醉期间的高氧化与不良的术后结果联系起来.
- 胸腔手术涉及到特定的程序,如一个肺透气 (OLV) 和肺重新扩张.
- 这些程序带有肺缺血-再输血损伤的风险.
研究的目的:
- 审查关于胸部外科手术中高氧化和术后结果的文献.
- 调查OLV和肺部再扩张期间吸入氧 (FiO2) 分数的作用.
- 在这种情况下,评估肺缺血-再输液损伤的风险.
主要方法:
- 在胸部麻醉中检查过氧的研究的文献综述.
- 分析与吸入氧气 (FiO2) 水平的分数相关的结果.
- 专注于外科手术前期,包括一次肺透气和肺再扩张.
主要成果:
- 胸部手术期间吸入氧气 (FiO2) 的较高部分与术后肺部结果较差相关.
- 一次肺呼吸会导致相对组织缺血.
- 缺血后肺部重新扩张可以引发缺血-再输血损伤.
结论:
- 在胸部手术中,限制吸入氧气 (FiO2) 的分量可能是有益的.
- 建议在一次肺通风和特别是在肺再扩张期间减少FiO2.
- 这种方法可以保护易受缺血-再输液损伤的肺膜.
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