Golden Leonard R, DeSimone Helen Ann, Yeroshalmi Farhad, Pranevicius Mindaugas, Saraghi Mana
Chairman, Department of Anesthesiology, Jacobi Medical Center, Bronx, NY, USA.
Anesth Prog. 2012 Fall;59(3):123-6. doi: 10.2344/12-00003.1.
Bronchospasm and status asthmaticus are two of the most dreaded complications that a pediatric anesthesiologist may face. With the occurrence of severe bronchospasm and the inability to ventilate, children are particularly vulnerable to apnea and ensuing hypoxia because of their smaller airway size, smaller lung functional residual capacity, and higher oxygen consumption rates than adults. Nebulized medication delivery in intubated children is also more difficult because of smaller endotracheal tube internal diameters. This case demonstrates the potentially lifesaving use of a vibrating-mesh membrane nebulizer connected to the anesthesia circuit for treating bronchospasm.
支气管痉挛和哮喘持续状态是儿科麻醉医生可能面临的两种最可怕的并发症。由于严重支气管痉挛的发生以及无法进行通气,儿童因其气道尺寸较小、肺功能残气量较小以及氧消耗率高于成人,特别容易发生呼吸暂停和随之而来的缺氧。由于气管内导管内径较小,给插管儿童雾化给药也更加困难。本病例展示了连接到麻醉回路的振动筛孔膜雾化器在治疗支气管痉挛方面可能挽救生命的应用。