高流量鼻氧与面罩通风用于非选择性手术患者的快速序列诱导:一种随机对照试验
Nguyen Duc Lam1,2, Le Dinh Thanh Son3, Tran Minh Phat3
1Department of Anesthesiology and Resuscitation, Hanoi Medical University, No. 01, Ton That Tung Street, Kim Lien Ward, Hanoi, 11520, Vietnam.
BMC anesthesiology
|January 31, 2026
概括
在非选择性手术中,高流量鼻腔管 (HFNC) 与面罩通风 (FMV) 相比,在快速序列诱导 (RSI) 中显著降低了氧气脱. HFNC改善了氧化,并且耐受性良好,没有增加胃或血液动力学并发症.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 非选择性手术往往需要快速序列诱导 (RSI) 由于不确定的禁食状态.
- 之前对RSI氧化的高流鼻腔管 (HFNC) 的研究已经产生了混合的结果.
- 这项研究研究了在非选择性手术患者的RSI期间的HFNC与面罩通风 (FMV) 的对比.
研究的目的:
- 为了比较HFNC和FMV在防止RSI期间氧气脱的有效性.
- 评估二次结果,包括二氧化碳积累,血液动力学,胃体积和患者舒适度.
主要方法:
- 一项随机对照研究,涉及成年ASA I-II患者接受非选择性手术.
- 在RSI期间,患者被分配给接受HFNC (100% O2,60 L·min-1) 或FMV (FiO2 1.0,10 L·min-1).
- 使用了修改后的RSI协议,以周管内氧化为主要结局.
主要成果:
- 在HFNC组中没有发生脱事件 (SpO2 < 94%),而在FMV组中为12.1% (p < 0.001).
- 在HFNC的结果中,氧化前和输液后的PaO2和潮末氧气度显著增加.
- 二氧化碳积累,血液动力学,胃体积和吸入发生率相似;在HFNC时注意到轻微的鼻腔干燥.
结论:
- 在低风险的非选择性手术患者中,HFNC在改善RSI期间的氧化方面似乎优于FMV.
- 在这个队列中,HFNC耐受性良好,并且没有增加胃或血液动力学并发症.
- 进一步的研究可能会探索HFNC在高风险手术群体中的实用性.
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