Pourmand Ali, Robinson Chelsea, Dorwart Kelsey, O'Connell Francis
Emergency Medicine Department, George Washington University, Washington, DC, United States.
Emergency Medicine Department, George Washington University, Washington, DC, United States.
Am J Emerg Med. 2017 Aug;35(8):1177-1183. doi: 10.1016/j.ajem.2017.06.006. Epub 2017 Jun 8.
Transient oxygen desaturation during emergency department intubation is an event with potentially devastating consequences. Pre-oxygenation is an important means of increasing a patient's oxygen reserve and duration of safe apnea prior to intubation. In the emergent setting, important modifications to pre-oxygenation techniques need to be considered to best manage critically ill patients. In this review, we discuss recent updates in pre-oxygenation techniques and evaluate the evidence supporting both commonly used and newly emerging techniques for pre-oxygenation, assessing nature and level of illness, the best delivery method of oxygen, using delayed sequence intubation in patients who cannot tolerate non-invasive pre-oxygenation and using apneic oxygenation via nasal cannula and non-rebreather mask during intubation.
急诊科插管期间的短暂性氧饱和度下降是一个可能产生毁灭性后果的事件。预给氧是增加患者氧储备以及插管前安全无呼吸持续时间的重要手段。在紧急情况下，需要考虑对预给氧技术进行重要改进，以最佳方式管理重症患者。在本综述中，我们讨论了预给氧技术的最新进展，并评估了支持常用和新出现的预给氧技术的证据，评估疾病的性质和严重程度、最佳的氧气输送方法、对无法耐受无创预给氧的患者使用延迟顺序插管，以及在插管期间通过鼻导管和非重复呼吸面罩进行无呼吸给氧。
