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剖宫产术中的插管期氧合:是否存在最佳技术?

Peri-intubation oxygenation for Caesarean delivery: is there an optimal technique?

机构信息

Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

University Hospitals of Leicester, Leicester, UK.

出版信息

Br J Anaesth. 2022 Oct;129(4):468-471. doi: 10.1016/j.bja.2022.07.014. Epub 2022 Aug 16.

Abstract

Peri-intubation oxygen administration to the pregnant patient during induction of general anaesthesia is critical to avoiding hypoxaemia and harm to the mother and fetus. Recent modelling comparing low-flow with high-flow nasal oxygen in simulated term pregnant women of varying body habitus, taken together with previous work, suggests that face mask preoxygenation with the use of low-flow or high-flow nasal oxygen during the period of apnoea prolongs the safe apnoea period, with the benefit varying by body habitus. Low-flow compared with high-flow nasal oxygen may be easier to combine with face mask preoxygenation and is readily available in all operating theatres, although future improvements in high-flow nasal oxygen delivery systems may improve ease of use for this indication.

摘要

在全身麻醉诱导期间向孕妇进行插管前给氧对于避免孕妇和胎儿缺氧和伤害至关重要。最近的模型比较了在不同体型的模拟足月孕妇中低流量与高流量鼻氧的情况,结合之前的工作,表明在呼吸暂停期间使用低流量或高流量鼻氧进行面罩预氧合可以延长安全呼吸暂停期,其益处因体型而异。与高流量鼻氧相比,低流量鼻氧可能更容易与面罩预氧合结合,并且在所有手术室都易于获得,尽管高流量鼻氧输送系统的未来改进可能会提高这种用途的易用性。

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