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首页> 外文期刊>Anaesthesia: Journal of the Association of Anaesthetists of Great Britain and Ireland >Apnoeic oxygenation with high-flow nasal oxygen for laryngeal surgery: a case series
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Apnoeic oxygenation with high-flow nasal oxygen for laryngeal surgery: a case series

机译:具有喉手术的高流量鼻氧气的Apnoeic氧合:案例系列

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Surgery under apnoeic conditions with the use of high-flow nasal oxygen is novel. Between November 2016 and May 2017, 28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high-flow nasal oxygen as the sole method of gas exchange. Patients received total intravenous anaesthesia and neuromuscular blocking agents for the duration of their surgery. The median (IQR [range]) apnoea time was 19 (15-24 [9-37]) min. Four patients experienced an episode of oxygen desaturation to a value between 85% and 90%, lasting less than 2 min in each case. Median (IQR [range]) end-tidal carbon dioxide (ETCO2) level following apnoea was 8.2 (7.2-9.4 [5.8-11.8]) kPa. The mean (SD) rate of ETCO2 increase was 0.17 (0.07) kPa. min(-1) from an approximated baseline value of 5.00 kPa. Venous blood sampling from 19 patients demonstrated a mean (SD) partial pressure of carbon dioxide (PVCO2) of 6.29 (0.71) kPa at baseline and 9.44 (1.12) kPa after 15 min of apnoea. This equates to a mean (SD) PVCO2 rise of 0.21 (0.08) kPa. min(-1) during this period. Mean (SD) pH was 7.40 (0.03) at baseline and 7.23 (0.04) after 15 min of apnoea. Mean (SD) standard bicarbonate was 26.7 (1.8) mmol.l(-1) at baseline and 25.4 (1.8) mmol.l(-1) at 15 min. We conclude that high-flow nasal oxygen under apnoeic conditions can provide satisfactory gas exchange in order to allow tubeless anaesthesia for laryngeal surgery.
机译:使用高流量鼻氧的邦内条件下的手术是新颖的。 2016年11月至2017年5月间,28名患者在具有高流量鼻氧的呼吸状况下进行无管喉或气管手术作为气体交换的唯一方法。患者在手术期间接受静脉内麻醉和神经肌肉阻断剂。中位数(IQR [RANGE])呼吸暂停时间为19(15-24 [9-37])min。四名患者经历了氧气消耗的一集,在85%至90%之间,每种情况下持续不到2分钟。中位数(IQR [RANGE])呼吸暂停后末端潮汐二氧化碳(ETCO2)水平为8.2(7.2-9.4 [5.8-11.8])KPA。 ETCO2增加的平均值(SD)率为0.17(0.07)KPa。 MIN(-1)从近似基线值为5.00kPa。从19名患者的静脉血液取样证明了在15分钟内的基线和9.44(1.12)KPA的6.29(0.71)KPa的平均(SD)部分压力。这相当于平均值(SD)PVCO2升高为0.21(0.08)KPa。在此期间min(-1)。平均值(SD)pH为7.40(0.03)在基线,呼吸暂停15分钟后7.23(0.04)。平均值(SD)标准碳酸氢盐在基线的26.7(1.8)mmol.1(-1),15分钟,25.4(1.8)mmol.L(-1)。我们得出结论,在渗透条件下的高流量鼻氧可以提供令人满意的气体交换,以便为喉手术进行无管麻醉。

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