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Medicine:使用喉罩而无胃管可导致胃胀气的发生

2017-06-01 MedSci MedSci原创

喉罩提供良好的气道密封,但是吸气峰压(PIP)超过喉罩密封压力而无胃管时可能会出现胃充气的情况。与容量控制通气(VCV)相比,压力控制通气(PCV)提供较低的PIP,较低的PIP可减少正压通气过程中小儿胃胀气的发生。本研究旨在评估小儿全麻手术中使用喉罩而无胃管的情况下,PIP、口咽漏气压和胃胀气的发生。 采用前瞻性随机对照研究设计,共纳入了34名儿童患者,年龄为6-84个月,随机分为VCV或

喉罩提供良好的气道密封,但是吸气峰压(PIP)超过喉罩密封压力而无胃管时可能会出现胃充气的情况。与容量控制通气(VCV)相比,压力控制通气(PCV)提供较低的PIP,较低的PIP可减少正压通气过程中小儿胃胀气的发生。本研究旨在评估小儿全麻手术中使用喉罩而无胃管的情况下,PIP、口咽漏气压和胃胀气的发生。

采用前瞻性随机对照研究设计,共纳入了34名儿童患者,年龄为6-84个月,随机分为VCV或PCV组。纤维支气管镜检查确保了喉罩的适当位置。喉罩插入后、经骶管阻滞后以及术后测量口咽漏气压和PIP。使用超声检测胃胀气。未插入胃管。

结果发现, 喉罩插入后、经骶管阻滞后以及术后PCV组PIP氧分压明显低于VCV组,分别为(10 [9–12] vs 12 [11–15], P =0 .021)、(11 [10–12] vs 13 [11–15], P = 0.014)及(10 [10–12] vs 13 [11–14], P =0 .002)。两组胃胀气的发生率并没有差异(VCV组4/17,PCV组3/17)(P > 0.999)。

总而言之,该研究发现,使用喉罩而不使用胃管,无论PIP采用哪种通风模式胃胀气均会发生。

原始出处:

Jin Ha Park, Ji Young Kim, A randomized comparison of volume- and pressure-controlled ventilation in children with the i-gel. Medicine (Baltimore). 2017 May; 96(18): e6772. Published online 2017 May 5. doi:  10.1097/MD.0000000000006772.

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    2018-04-27 爆笑小医
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    2018-01-07 jeanqiuqiu
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    2017-06-01 有备才能无患

    ,该研究发现,使用喉罩而不使用胃管,无论PIP采用哪种通风模式胃胀气均会发生。

    0

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