Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA, USA.
Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
Br J Anaesth. 2017 Mar 1;118(3):344-354. doi: 10.1093/bja/aex004.
Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation.
We performed a comprehensive, systematic review to identify and catalogue published instances of aspiration involving procedural sedation in patients of all ages. We sought to report descriptively the circumstances, nature, and outcomes of these events.
Of 1249 records identified by our search, we found 35 articles describing one or more occurrences of pulmonary aspiration during procedural sedation. Of the 292 occurrences during gastrointestinal endoscopy, there were eight deaths. Of the 34 unique occurrences for procedures other than endoscopy, there was a single death in a moribund patient, full recovery in 31, and unknown recovery status in two. We found no occurrences of aspiration in non-fasted patients receiving procedures other than endoscopy.
This first systematic review of pulmonary aspiration during procedural sedation identified few occurrences outside of gastrointestinal endoscopy, with full recovery typical. Although diligent caution remains warranted, our data indicate that aspiration during procedural sedation appears rare, idiosyncratic, and typically benign.
虽然全身麻醉手术中并发肺吸入已得到广泛研究，但对于程序镇静期间的吸入知之甚少。
我们进行了全面的系统评价，以确定并分类发表的涉及所有年龄段患者的程序镇静吸入事件。我们旨在描述这些事件的情况、性质和结果。
通过我们的搜索共确定了 1249 条记录，其中 35 篇文章描述了程序镇静期间发生的一次或多次肺吸入。在胃肠内镜检查的 292 次发生中，有 8 例死亡。在非内镜程序的 34 个独特发生中，1 例濒死患者死亡，31 例完全恢复，2 例恢复情况未知。我们未发现非禁食患者在接受非内镜程序时发生吸入。
这是首次对程序镇静期间肺吸入进行的系统评价，发现除胃肠内镜检查外，吸入的发生率很低，且通常预后良好。尽管仍需谨慎，但我们的数据表明，程序镇静期间的吸入似乎很少见、特发性且通常良性。
