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全身麻醉气管插管拔管后非ICU患者声学呼吸频率监测期间氧饱和度降低的回顾性分析

A Retrospective Analysis of Oxygen Desaturation during Acoustic Respiratory Rate Monitoring in Non-ICU Patients following Tracheal Extubation after General Anesthesia.

作者信息

Kawanishi Hideaki, Inoue Satoki, Kawaguchi Masahiko

机构信息

Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.

出版信息

Anesthesiol Res Pract. 2017;2017:4203156. doi: 10.1155/2017/4203156. Epub 2017 Apr 12.

Abstract

. Acoustic respiratory rate (RRa) monitoring provides an accurate estimation of the respiratory rate (RR). We investigated the incidence of oxygen desaturation under RRa monitoring in a postoperative setting and identified its related factors. . This study was a retrospective chart review of postoperative patients outside an intensive care unit setting. Using the data collected during the first 8 h postoperatively, patients were divided into oxygen desaturated (SpO < 90% for >10 s) and nondesaturated groups under oxygen administration. Multivariate analysis was used to determine oxygen desaturation-associated explanatory factors. . Oxygen desaturation was detected in 102 of 935 patients (10.9%). % vital capacity [odds ratio (OR), 0.885 per 10% increase; 95% confidence interval (CI), 0.790 to 0.992], coexisting chronic obstructive pulmonary disease (OR, 2.195; 95% CI, 1.088 to 4.428), and absence of a critical RRa change (RR > 30 or <8 beats/min for >2 min) (OR, 1.972; 95% CI, 1.226 to 3.172) were independently associated with oxygen desaturation. . Postoperative oxygen desaturation was observed in more than 10% of the patients whose RR was monitored by RRa under oxygen therapy. It is more likely to occur in patients with impaired pulmonary function or morbid pulmonary status and can also occur in the absence of abnormal RR.

摘要

. 声学呼吸频率(RRa)监测可准确估算呼吸频率(RR)。我们调查了术后环境中RRa监测下氧饱和度降低的发生率,并确定了其相关因素。. 本研究是对重症监护病房以外的术后患者进行的回顾性病历审查。利用术后前8小时收集的数据,将吸氧患者分为氧饱和度降低组(SpO<90%超过10秒)和未降低组。采用多变量分析确定与氧饱和度降低相关的解释因素。. 935例患者中有102例(10.9%)检测到氧饱和度降低。肺活量百分比[比值比(OR),每增加10%为0.885;95%置信区间(CI),0.790至0.992]、并存慢性阻塞性肺疾病(OR,2.195;95%CI,1.088至4.428)以及无RRa临界变化(RR>30或<8次/分钟超过2分钟)(OR,1.972;95%CI,1.226至3.172)与氧饱和度降低独立相关。. 在接受氧疗且通过RRa监测RR的患者中,超过10%的患者术后出现氧饱和度降低。它更易发生于肺功能受损或存在病态肺部状况的患者,也可能在RR无异常时发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8caf/5405372/c85315a32fc0/ARP2017-4203156.001.jpg

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