Frame S B, Timberlake G A, Kerstein M D, Money M K, Hendrickson M F, Akers D L, McSwain N E
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Ann Emerg Med. 1989 Feb;18(2):127-33. doi: 10.1016/s0196-0644(89)80100-3.
Transtracheal needle catheter ventilation (TNCV) may be used as an alternative airway when contraindications to endotracheal intubation exist. A feline model tested the efficacy of low-flow oxygen delivery, and initial data were gathered to define proper catheter calibers to effect adequate oxygenation and ventilation. Cats were anesthetized, trachea intubated, and ventilated for 30 minutes with a pressure-regulated ventilator. Arterial and venous pressures were monitored, and a chest tube was inserted to measure intrathoracic pressures. Arterial blood gas analysis was performed every five minutes during the baseline period. The endotracheal tube was then removed, the trachea cross-clamped, and TNCV instituted. Oxygen flow rates of 1, 3, and 5 L/min were varied with catheter sizes of 14, 16, and 18 g. Data demonstrated that TNCV provided adequate oxygenation and ventilation with flow rates of 3 and 5 L/min with the 14- and 16-g catheters. Satisfactory oxygenation could be obtained with these flow rates with the 18-g catheter, but ventilation was inadequate. Ventilation was unsatisfactory with the 1 L/min flow rate in all catheter sizes. These preliminary data indicate that a minimum catheter:trachea cross-sectional area ratio of 0.03 may be required to obtain oxygenation and ventilation with low-flow oxygen rates of 3 to 5 L/min in cats.
当存在气管插管禁忌证时，经气管穿刺针导管通气（TNCV）可作为一种替代气道使用。一个猫科动物模型测试了低流量氧气输送的效果，并收集了初始数据以确定合适的导管口径，以实现充足的氧合和通气。猫被麻醉、气管插管，并用压力调节呼吸机通气30分钟。监测动脉和静脉压力，并插入胸管以测量胸内压力。在基线期每五分钟进行一次动脉血气分析。然后移除气管内导管，夹闭气管，并开始TNCV。氧气流速为1、3和5升/分钟，导管尺寸分别为14、16和18号。数据表明，使用14号和16号导管，TNCV在3升/分钟和5升/分钟的流速下可提供充足的氧合和通气。使用18号导管，在这些流速下可获得满意的氧合，但通气不足。在所有导管尺寸中，1升/分钟的流速通气效果均不理想。这些初步数据表明，在猫中，可能需要最小导管与气管横截面积比为0.03，才能在3至5升/分钟的低流量氧气流速下实现氧合和通气。
