Stothert J C, Stout M J, Lewis L M, Keltner R M
University of Texas Medical Branch, Department of Surgery, Galveston 77550.
Am J Emerg Med. 1990 May;8(3):184-9. doi: 10.1016/0735-6757(90)90318-t.
Percutaneous transtracheal ventilation using a large gauge intravenous-type catheter can be used successfully in the setting of complete upper airway obstruction in animals. In this study, using a large animal model, satisfactory oxygenation and ventilation was achieved by inversely varying the catheter size and the inspiration to expiration ratio (I:E). Specifically, 30 to 63 kg ruminants with an obstructed upper airway were resuscitated for 30 minutes from a hypoxic, hypercarbic, and acidotic state using 12- and 14-gauge catheters connected to a 50 psi oxygen source via a two-way valve with an I:E of 1:4 and 1:9 seconds, respectively. Shorter expiratory time or increased inspiratory time with these intravenous catheters resulted in significant hemodynamic compromise, barotrauma, inadequate carbon dioxide elimination, acidemia, and frequent death.
使用大口径静脉输液式导管进行经皮气管通气可成功应用于动物完全上呼吸道梗阻的情况。在本研究中，采用大型动物模型，通过反向改变导管尺寸和吸气与呼气比（I:E）实现了满意的氧合和通气。具体而言，对30至63千克上呼吸道梗阻的反刍动物，使用12号和14号导管，通过双向阀连接到50 psi氧气源，I:E分别为1:4秒和1:9秒，使其从缺氧、高碳酸血症和酸中毒状态复苏30分钟。使用这些静脉导管时，较短的呼气时间或增加的吸气时间会导致显著的血流动力学损害、气压伤、二氧化碳清除不足、酸血症和频繁死亡。
