Craven Rachael M, Laver Stephen R, Cook Tim M, Nolan Jerry P
Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, United Kingdom.
Can J Anaesth. 2003 Aug-Sep;50(7):718-20. doi: 10.1007/BF03018716.
To study the feasibility of using the Pro-Seal laryngeal mask airway (LMA) for airway maintenance during bronchoscopic guided percutaneous tracheostomy.
Observational study of 23 patients in an 11-bed general intensive care unit. The patient's tracheal tube was exchanged for a Pro-Seal LMA before undertaking percutaneous tracheostomy.
Inspiratory pressure and tidal volumes achieved during the procedure were recorded. The median peak inspiratory pressure was 25 (standard deviation 4.2) cm H(2)O. There was no loss of tidal volume in 11 patients, a loss of less than 100 mL x breath(-1) in 11, and loss of more than 100 mL in one. A Pro-Seal LMA successfully maintained the airway and allowed adequate ventilation during percutaneous tracheostomy in all 23 patients. In all patients bronchoscopy through the Pro-Seal LMA provided a clear view of the cords and trachea and there was no laryngeal or tracheal soiling at any stage of the procedure.
The Pro-Seal LMA provides a reliable airway and allows effective ventilation during percutaneous tracheostomy. The passage of a fibrescope through the Pro-Seal LMA and glottis is easy and provides a clear view of the upper trachea.
研究在支气管镜引导下经皮气管切开术中使用食管引流型喉罩气道(LMA)维持气道的可行性。
在一个拥有11张床位的综合重症监护病房对23例患者进行观察性研究。在进行经皮气管切开术前,将患者的气管导管更换为食管引流型喉罩气道。
记录手术过程中达到的吸气压力和潮气量。吸气峰压中位数为25(标准差4.2)cm H₂O。11例患者潮气量无损失;11例患者潮气量损失小于100 mL·次⁻¹;1例患者潮气量损失超过100 mL。在所有23例患者的经皮气管切开术中,食管引流型喉罩气道均成功维持气道并实现了充分通气。在所有患者中,通过食管引流型喉罩气道进行支气管镜检查时,声带和气管视野清晰,且在手术的任何阶段均未出现喉或气管污染。
食管引流型喉罩气道可提供可靠的气道,并在经皮气管切开术中实现有效通气。纤维支气管镜通过食管引流型喉罩气道和声门很容易,且能清晰显示气管上段。