经皮扩张气管切开术时 LMA classic 用于气管插管对通气的影响。
Effects of tracheal intubation on ventilation with LMA classic for percutaneous dilation tracheostomy.
出版信息
Minerva Anestesiol. 2010 Mar;76(3):181-7.
AIM
The classic laryngeal mask airway (cLMATM) can be used in place of an endotracheal tube (ETT) as the ventilatory device during percutaneous dilational tracheostomy (PDT). We aimed to investigate the possible loss of efficacy of cLMATM after tracheal intubation.
METHODS
Severity of laryngeal lesions and efficacy of cLMATM were determined in two groups of thirty patients each who were switched from ETT ventilation to cLMA ventilation for PDT after a short (<4 days) or a long (>12 days) tracheal intubation.
RESULTS
cLMATM allowed us to carry out PDT in all patients. Short tracheal intubations resulted in mild lesions of the larynx and mild gas leaks during cLMATM ventilation. Longer intubations caused moderate-to-severe (P<0.05) lesions of the larynx and larger gas leaks. A single complication occurred in one patient post-procedurally and in no patient at 6-month follow-up.
CONCLUSION
Efficacy of cLMATM was maintained after short tracheal intubation and decreased after long intubation.
目的
经典型喉罩气道（cLMATM）可替代气管内导管（ETT）作为经皮扩张气管切开术（PDT）中的通气装置。我们旨在研究气管插管后 cLMATM 可能失效的原因。
方法
将 30 例患者分为两组，每组 30 例，在短时间（<4 天）或长时间（>12 天）气管插管后，将 ETT 通气切换为 cLMA 通气，以确定喉损伤的严重程度和 cLMATM 的效果。
结果
cLMATM 允许我们对所有患者进行 PDT。短时间的气管插管导致轻度的喉部损伤和 cLMATM 通气时轻度的气体泄漏。较长的插管导致中度至重度（P<0.05）的喉部损伤和更大的气体泄漏。术后仅 1 例患者出现单一并发症，6 个月随访时无患者出现并发症。
结论
cLMATM 的效果在短时间的气管插管后得以维持，而在长时间的插管后则下降。
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