国际麻醉学与复苏杂志   2012, Issue (3): 7-7
    
重症监护室内急救插管预氧合的研究现状
李海波, 冯婷婷1()
1.哈尔滨医科大学附属第二医院重症医学科(ICU-A区)
The current clinical research of preoxygenation before emergency tracheal intubation in ICU
 全文:
摘要:

背景 预氧合是进行气管插管的必要程序之一,但由于临床证据不足,预氧合并未在ICU内得到普及和重视。关于手术室内麻醉预氧合的研究较多,ICU内急救插管预氧合的研究才刚刚起步。 目的 对ICU内预氧合的相关技术、实施,以及存在的问题、今后的发展进行探讨。 内容 对ICU急救插管的患者进行预氧合能够有效地增加患者的氧气储备量,延长患者耐受窒息的时间,延迟氧合血红蛋白的解离,降低低氧血症的发生率,要尽量避免预氧合所造成的胃胀气等副作用。在多种预氧合的方式中,传统的气囊-面罩预氧合的效果不如其他方式的预氧合,由于缺乏足够的临床证据,效果较好的预氧合方式并未广泛应用于临床工作中。 趋向 为了探寻更好的ICU内预氧合方式,有必要进行更广泛深入的临床研究。

关键词: ICU 急救气管插管 预氧和
Abstract:

Background Preoxygenation is one of the necessary procedures before tracheal intubation, but hadn’t been emphasized and popularized in ICU because of lacking of clinical evidences. Much work of preoxygenation before elective general anesthesia, has been done, but the study in ICU has just begun. Objective The summary discussed the relevant techniques , practice, problems and future development of .preoxygenation in ICU. Content Preoxygenation in critically ill patients requiring emergency tracheal intubation increases oxygen reserves and duration of apnea without desaturation (DAWD) in the hopes of delaying the onset of arterial desaturation , thus prevents hypoxia during a planned or unexpected period of apnea . Side effects of preoxygenation such as stomach inflation should be prevented. Traditional manner of preoxygenation (bag-valve-mask ventilation) is less effective at reducing arterial oxyhemoglobin desaturation than other methods. Lacking of adequate clinical evidences, those effective metoods of preoxygenation weren’t widely used in clinical practice Trend In order to explore a optimal preoxygenation method in ICU, further clinical studies is needed.

Key words: ICU ; Emergency tracheal intubation ; Preoxygenation