Fassoulaki A, Eforakopoulou M, Vassiliou M
Department of Intensive Care Unit, St Savas Hospital, Athens, Greece.
Anesth Analg. 1989 Feb;68(2):112-5. doi: 10.1213/00000539-198902000-00008.
The effect of nasotracheal intubation on oxygen consumption (VO2), carbon dioxide production (VCO2), and resting energy expenditure (REE) was studied in 12 critically ill patients. All patients were given midazolam 0.3 mg/kg and etomidate 0.3 mg/kg followed by 8 mg of vecuronium to facilitate intubation. After nasotracheal intubation the patients were mechanically ventilated with an Erica Engström ventilator and connected to an Engström metabolic computer (EMC). Carbon dioxide production was measured using an infrared CO2 analyzer. Resting energy expenditure was calculated by the EMC, which incorporated an oxygen cell for VO2 measurement. VO2, VCO2, and REE were recorded 5, 10, 15, 20, 25, and 30 minutes after intubation. High values of the above parameters were observed 5 minutes after intubation, values that gradually declined during the next 25 minutes. At 25 and 30 minutes after intubation VO2 was 25% and 27% lower (P = 0.054) than the VO2 at 5 minutes after intubation. Carbon dioxide production and REE were also lower 10, 15, 20, 25, and 30 minutes after intubation but were not significantly different from values obtained at 5 minutes. The increase in VO2 associated with nasotracheal intubation may be detrimental for patients already suffering from hypoxia.
对12例重症患者研究了经鼻气管插管对氧耗量（VO2）、二氧化碳生成量（VCO2）和静息能量消耗（REE）的影响。所有患者均给予咪达唑仑0.3mg/kg和依托咪酯0.3mg/kg，随后给予8mg维库溴铵以利于插管。经鼻气管插管后，患者用埃里卡·恩斯特龙呼吸机进行机械通气，并连接到恩斯特龙代谢计算机（EMC）。使用红外CO2分析仪测量二氧化碳生成量。静息能量消耗由EMC计算得出，EMC包含一个用于测量VO2的氧传感器。在插管后5、10、15、20、25和30分钟记录VO2、VCO2和REE。插管后5分钟观察到上述参数值较高，在接下来的25分钟内这些值逐渐下降。插管后25和30分钟时，VO2比插管后5分钟时低25%和27%（P = 0.054）。插管后10、15、20、25和30分钟时二氧化碳生成量和REE也较低，但与5分钟时获得的值无显著差异。与经鼻气管插管相关的VO2增加可能对已患有缺氧的患者有害。
