Ittner K P, Bialek R
Institut für Anästhesiologie und Intensivmedizin, Marienkrankenhaus Amberg.
Anaesthesist. 1992 Oct;41(10):644-6.
Technical problems during anaesthesia are important causes of anaesthesia-related deaths and brain damage. During general endotracheal anaesthesia for ophthalmic surgery (41-year-old man, ASA 1) we observed an increase in inspiratory pressure without other clinical changes. Disconnection and ventilation with a resuscitation bag showed normal inspiratory pressures. Inspection demonstrated an obstruction due to an aneurysm of the inner layer of the inspiratory tubing. The classification of this rare blockage of ventilation differs in the literature (pressure, hypoventilation, hypercarbia). In addition, it demonstrates the principal problem of clinical decision-making during anaesthesia based on monitoring information. Strategies for responding to alarms indicating hazards of ventilation must be based on immediate restoration of sufficient ventilation, and not primarily on detecting the cause.
麻醉期间的技术问题是导致与麻醉相关的死亡和脑损伤的重要原因。在为一名41岁男性（ASA 1级）进行眼科手术的全身气管内麻醉过程中，我们观察到吸气压力升高，而无其他临床变化。断开连接并用复苏袋进行通气时，吸气压力显示正常。检查发现是由于吸气管道内层的一个动脉瘤导致阻塞。这种罕见的通气阻塞在文献中的分类有所不同（压力、通气不足、高碳酸血症）。此外，它还说明了基于监测信息进行麻醉期间临床决策的主要问题。应对指示通气危险的警报的策略必须基于立即恢复足够的通气，而不是主要基于查明原因。
