Morath Ute, Gendron Karine, Revés Nuria Vizcaíno, Adami Chiara
From the Anesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science Vetsuisse Faculty, Berne, Switzerland.
J Am Anim Hosp Assoc. 2015 Jan-Feb;51(1):36-42. doi: 10.5326/JAAHA-MS-6022. Epub 2014 Nov 21.
The authors describe two animals (one dog and one cat) that were presented with severe respiratory distress after trauma. Computerized tomographic imaging under general anesthesia revealed, in both cases, complete tracheal transection. Hypoxic episodes during anesthesia were relieved by keeping the endotracheal tube (ETT) positioned in the cranial part of the transected trachea and by allowing spontaneous breathing. Surgical preparation was performed quickly, and patients were kept in a sternal position to improve ventilation and oxygenation, and were only turned into dorsal recumbency shortly before surgical incision. A sterile ETT was guided into the distal part of the transected trachea by the surgeon, at which point mechanical ventilation was started. Both animals were successfully discharged from hospital a few days after surgery. Rapid and well-coordinated teamwork seemed to contribute to the good outcome. Precise planning and communication between anesthetists, surgeons, and technicians, as well as a quick course of action prior to correct ETT positioning helped to overcome critical phases.
作者描述了两只动物(一只狗和一只猫),它们在创伤后出现严重呼吸窘迫。全身麻醉下的计算机断层扫描成像显示,在这两个病例中均存在气管完全横断。通过将气管内导管(ETT)置于横断气管的头侧部分并允许自主呼吸,缓解了麻醉期间的缺氧发作。迅速进行手术准备,患者保持胸骨位以改善通气和氧合,仅在手术切口前不久转为仰卧位。外科医生将无菌ETT导入横断气管的远端部分,此时开始机械通气。两只动物均在手术后几天成功出院。快速且协调良好的团队合作似乎促成了良好的结果。麻醉师、外科医生和技术人员之间的精确规划和沟通,以及在正确放置ETT之前的快速行动过程,有助于克服关键阶段。