Rosenblatt William H
Department of Anesthesiology and Surgery, Yale University School of Medicine, New Haven, Connecticut.
Anesth Analg. 2003 Dec;97(6):1773-1775. doi: 10.1213/01.ANE.0000085300.41506.EF.
Insufflation of the stomach with air can be a complication of face mask ventilation in the case of airway obstruction. Although the laryngeal mask airway has proven value in airway resuscitation, it has two major failings: a relatively low seal pressure and lack of access to the alimentary tract. A case is reported in which failed intubation (by multiple techniques) and intermittent face mask ventilation resulted in gastric distension, decreased airway compliance, and compromised gas exchange. The patient experience oxyhemoglobin saturation that did not improve despite laryngeal mask ventilation. The patient was resuscitated with a LMA-ProSeal, which permitted ventilation with high airway pressures. Return of oxyhemoglobin saturation occurred after decompression of the stomach with a gastric tube inserted via the LMA-ProSeal's gastric drain.
在气道阻塞的情况下,通过面罩通气向胃内注入空气可能是一种并发症。尽管喉罩气道在气道复苏中已被证明有价值,但它有两个主要缺点:密封压力相对较低以及无法进入消化道。本文报告了一例病例,多次插管技术失败以及间歇性面罩通气导致胃扩张、气道顺应性降低和气体交换受损。尽管进行了喉罩通气,患者的氧合血红蛋白饱和度仍未改善。使用LMA-ProSeal对患者进行复苏,该喉罩允许进行高气道压力通气。通过经LMA-ProSeal的胃引流管插入胃管对胃进行减压后,氧合血红蛋白饱和度恢复。