Improvement of gas exchange by apneic oxygenation with nasal prong during fiberoptic intubation in fully relaxed patients

在完全放松的患者中,通过鼻导管进行呼吸暂停氧合,在纤维支气管镜插管期间改善气体交换

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Abstract

To evaluate the effect of apneic oxygenation with a nasal prong during fiberoptic orotracheal intubation (FOI) in fully relaxed patients, 46 patients, who underwent tympanomastoidectomy under general anesthesia whose intubation lasted more than 3 but less than 4 minutes, were studied. Changes of arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2) and vital signs were measured every minute. Twenty-three patients who underwent FOI in apneic state without oxygen administration (Group I), showed similar increases in heart rate (HR) and mean arterial pressure (MAP) to the other 23 patients who received 5 L/min of apneic oxygenation (Group II) with nasal prong. PaCO2 increased less and PaO2 decreased less in Group II at 3 minutes. In summary, apneic oxygenation during fiberoptic orotracheal intubation in fully relaxed patients is useful because it could delay the onset of hypoxia and hypercarbia, thereby providing extra time for intubation. And attempts to intubate a fully relaxed patient could probably be kept at least under 3 minutes.

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