预充氧和脉搏血氧饱和度监测可能会延迟食管插管的检测。
Preoxygenation and pulse oximetry may delay detection of esophageal intubation.
作者信息
McShane A J, Martin J L
出版信息
J Natl Med Assoc. 1987 Sep;79(9):987, 991-2.
A case of delayed detection of esophageal intubation is described. Preoxygenation and pulse oximetry were used, and the first indication of tube misplacement was arterial desaturation indicated by the pulse oximeter. The combination of preoxygenation and pulse oximetry may contribute to delays in early detection of endotracheal tube misplacement for the following reasons: (1) preoxygenation results in a pulmonary reservoir of oxygen sufficient to maintain arterial hemoglobin saturation for an extended period of time; and (2) the maintenance of normal arterial saturations for an extended period after inadvertent esophageal tube placement may lead the practitioner to initially seek other causes of declining oxygen saturations. Although pulse oximetry is an acknowledged advance in patient monitoring, it must not be utilized as an early indication of correct endotracheal tube placement.
本文描述了一例食管插管延迟发现的病例。采用了预给氧和脉搏血氧饱和度监测，而导管误置的首个迹象是脉搏血氧仪显示的动脉血氧饱和度下降。预给氧和脉搏血氧饱和度监测相结合可能会导致气管内导管误置早期发现延迟，原因如下：（1）预给氧会在肺部形成一个氧气储备库，足以在较长时间内维持动脉血红蛋白饱和度；（2）意外食管置管后长时间维持正常动脉饱和度可能会使从业者最初去寻找血氧饱和度下降的其他原因。尽管脉搏血氧饱和度监测是患者监测方面公认的一项进展，但绝不能将其用作气管内导管正确置入的早期指标。
Zotero 插件