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不同新鲜气流对碳氧血红蛋白水平的影响:非侵入性一氧化碳监测:一项随机临床试验。

Effects of different fresh gas flows on carboxyhemoglobin levels: non-invasive carbon monoxide monitoring: A randomized clinical trial.

机构信息

From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.

出版信息

Saudi Med J. 2022 Aug;43(8):891-898. doi: 10.15537/smj.2022.43.8.20220424.

Abstract

OBJECTIVES

To observe the effect of different fresh gas flows (FGF) on carboxyhemoglobin (COHb) levels non-invasively and continuously and to determine the contribution of the smoking status to intraoperative carbon monoxide (CO) accumulation and respiratory complications.

METHODS

A total of 64 patients were included in the study. Carboxyhemoglobin level was monitored non-invasively from the fingertip. Patients were divided into 2 according to the FGF as low-flow anesthesia (LFA; Group L) and high flow anesthesia (Group H). Each group was divided again into 2 groups as smokers and non-smokers. Carboxyhemoglobin and and the respiratory complications that occurred in the post-anesthesia care unit were recorded.

RESULTS

The mean COHb values were significantly higher in Group L between 30th and 210th minutes. Furthermore, in Group L, intraoperative COHb levels were significantly higher in smokers compared to non-smokers in all periods. In group H, no difference was observed between smokers and non-smokers in terms of COHb levels after 60 minutes and also preoperative COHb levels of the patients developed respiratory complication was higher.

CONCLUSION

If the CO absorbent is properly preserved in patients who are administered LFA, there will be no risk of CO accumulation even in chronic smokers..

摘要

目的

观察不同新鲜气流(FGF)对无创连续监测碳氧血红蛋白(COHb)水平的影响,并确定吸烟状况对术中一氧化碳(CO)蓄积和呼吸并发症的影响。

方法

共纳入 64 例患者。通过指尖无创监测碳氧血红蛋白水平。根据 FGF 将患者分为低流量麻醉(LFA;L 组)和高流量麻醉(H 组)。每组再分为吸烟者和非吸烟者两组。记录 COHb 及麻醉后监护病房发生的呼吸并发症。

结果

L 组在第 30 至 210 分钟时 COHb 值明显升高。此外,在 L 组中,吸烟者在所有时间段的 COHb 水平均明显高于非吸烟者。在 H 组中,60 分钟后吸烟者和非吸烟者的 COHb 水平无差异,且发生呼吸并发症的患者术前 COHb 水平较高。

结论

如果在接受 LFA 的患者中妥善保存 CO 吸收剂,即使是慢性吸烟者也不会有 CO 蓄积的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40c1/9749675/c1553c69a89b/smj-43-8-891_page_4_1.jpg

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