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[新型双腔导管支气管灌洗的有效性]

[Effectiveness of bronchial lavage with a new double-lumen catheter].

作者信息

Schmidt C, Schön R, Russ J

机构信息

Medizinische Poliklinik, Rheinischen Friedrich-Wilhelms-Universität Bonn.

出版信息

Anaesthesist. 1988 Jun;37(6):392-5.

PMID:3407905
Abstract

The effectiveness of tracheobronchial lavage in the traditional manner with application of a rinsing solution into the endotracheal tube of artificially ventilated patients is unsatisfactory. In order to improve this a new double lumen catheter was developed. Beside the suction channel with a normal diameter is another very small channel, through which a rinsing solution or drugs can easily be applied endobronchially. The rinsing solution can be poured with high speed through this small channel into the peripheral bronchi. In comparison with the traditional method, endobronchial saline instillation and suctioning can be done more quickly during continuous artificial respiration. The tube was compared with a common suction catheter in 16 patients. These patients were intubated and given artificial respiration. Endobronchial rinsing and suctioning were done periodically. The suctioned bronchial secretion was measured and arterial blood gases were evaluated. Using the dual lumen probe, the suctioned volume was 3.8 times higher. In a short time the arterial oxygen pressure rose from 100% to 123%. An obvious improvement in ventilation could be seen even after 1 h. There was a positive correlation between the suctioned volume and the rise in oxygen pressure. Only suctioning of more than 3.7 ml was accompanied by a rise in the arterial oxygen pressure. Because of continuous artificial respiration, the arterial carbon dioxide pressure was kept constant. Therefore, there is a catheter available that makes it possible to perform a much more effective endobronchial lavage in a shorter period of time.

摘要

以传统方式向人工通气患者的气管内导管中注入冲洗液进行气管支气管灌洗,其效果并不理想。为了改善这一情况,研发了一种新型双腔导管。除了具有正常直径的吸引通道外,还有另一个非常小的通道,通过该通道可以很容易地将冲洗液或药物经支气管内注入。冲洗液可以通过这个小通道高速注入外周支气管。与传统方法相比,在持续人工呼吸过程中,经支气管内注入生理盐水和抽吸操作可以更快地完成。将该导管与普通吸引导管在16例患者中进行了比较。这些患者均已插管并接受人工呼吸。定期进行经支气管冲洗和抽吸。测量抽吸的支气管分泌物量并评估动脉血气。使用双腔探头时,抽吸量高出3.8倍。在短时间内,动脉血氧分压从100%升至123%。即使在1小时后也能看到通气有明显改善。抽吸量与血氧分压升高之间存在正相关。只有抽吸量超过3.7 ml时,动脉血氧分压才会升高。由于持续人工呼吸,动脉血二氧化碳分压保持恒定。因此,有一种导管可供使用,它能够在更短的时间内进行更有效的经支气管灌洗。

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