Biscoping J, Michaelis G, Hempelmann G
Abteilung für Anaesthesiologie und operative Intensivmedizin, Justus-Liebig-Universität, Giessen.
Anaesthesist. 1988 Jul;37(7):450-1.
We report an intraoperative complication caused by nitrous oxide diffusion through the inner layer of a tube of the Ulmer breathing system, which has been developed for ventilation of small children and neonates (Fig. 2a). About 40 min after intubation and mechanical ventilation with oxygen, nitrous oxide, and halothane a sudden rise in PETCO2 was noticed (Fig. 1). Auscultation of both lungs revealed no pathological finding; suction through the endotracheal tube was possible with no indication of endotracheal tube herniation. After reconnection to the ventilator, PETCO2 values again increased. Thorough inspection of the tubes of the Ulmer breathing system revealed a herniation that nearly occluded the lumen (Fig. 2b). After changing the anesthetic system, the operation and anesthesia were continued uneventfully.
我们报告了一例术中并发症，该并发症是由一氧化二氮透过乌尔默呼吸系统管道内层扩散所致，该系统专为小儿和新生儿通气而设计（图2a）。在插管并用氧气、一氧化二氮和氟烷进行机械通气约40分钟后，发现呼气末二氧化碳分压（PETCO2）突然升高（图1）。双肺听诊未发现病理征象；通过气管内导管进行吸引可行，未提示气管内导管疝。重新连接呼吸机后，PETCO2值再次升高。对乌尔默呼吸系统的管道进行彻底检查发现一处疝，几乎阻塞了管腔（图2b）。更换麻醉系统后，手术和麻醉继续顺利进行。
