Dunford M, Donoghue J, Lazaris M
Acute Care Nursing research Unit, St George Public Hospital, Kogarah, NSW, Australia.
Heart Lung. 1999 Sep-Oct;28(5):348-51. doi: 10.1053/hl.1999.v28.a99956.
A woman with obstructive sleep apnea who was admitted to the sleep disorders laboratory at St George Hospital in Sydney, Australia, for assessment subsequently experienced respiratory arrest. She was successfully resuscitated and 10 days later was transferred from the critical care unit to the respiratory ward with a cuffed, fenestrated tracheostomy tube in situ. A hoarse voice, oxygen desaturation, and upper airway stridor when capping the tracheostomy alerted nursing staff to the existence of an upper airway obstruction. Repositioning of the tracheostomy tube alleviated some of the patient's difficulties, but further investigation revealed large vocal polyps as the underlying factor in her episode of respiratory failure. Removal of the polyps and inception of noninvasive positive pressure ventilation resulted in a range of benefits to the patient's health status, including resolution of her respiratory failure, better management of her diabetes, and a markedly improved quality of life.
一名患有阻塞性睡眠呼吸暂停的女性被送往澳大利亚悉尼圣乔治医院的睡眠障碍实验室进行评估，随后出现了呼吸骤停。她成功复苏，10天后从重症监护病房转到呼吸病房，当时气管切开套管带套囊且有开窗，仍留置在原位。封堵气管切开套管时出现声音嘶哑、氧饱和度下降和上呼吸道喘鸣，这引起了护理人员对存在上呼吸道梗阻的警觉。重新调整气管切开套管的位置缓解了患者的一些困难，但进一步检查发现大的声带息肉是其呼吸衰竭发作的潜在因素。切除息肉并开始无创正压通气给患者的健康状况带来了一系列益处，包括呼吸衰竭的缓解、糖尿病的更好控制以及生活质量的显著改善。
