Das Neves Coelho Francisco, Alves Rui, Raposo Carlos
Helicopter Emergency Medical Services, Instituto Nacional de Emergencia Medica, Lisboa, PRT.
Intensive Care, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, PRT.
Cureus. 2023 Jul 3;15(7):e41317. doi: 10.7759/cureus.41317. eCollection 2023 Jul.
The classic out-of-hospital approach to a patient with severe acute respiratory failure involves both orotracheal intubation and invasive mechanical ventilation. The use of non-invasive methods for respiratory support has been shown to be beneficial in managing both acute and chronic respiratory failure. However, its use had not been previously considered for air medical transport due to concerns related to airway safety during flight, limited oxygen availability, and limited experience in this setting. We describe the successful inter-hospital helicopter transport of a patient with end-stage lung disease to a transplantation unit while utilizing a high-flow oxygen cannula, which was performed without significant complications. Our successful case report raises the possibility that high-flow nasal cannulas may be safely employed in the management of respiratory failure in specific patient populations during air medical transport.
对于严重急性呼吸衰竭患者,传统的院外救治方法包括经口气管插管和有创机械通气。已证明使用无创方法进行呼吸支持对急性和慢性呼吸衰竭的管理均有益处。然而,由于担心飞行过程中的气道安全、氧气供应有限以及在此环境下经验不足,此前未考虑在航空医疗转运中使用这种方法。我们描述了一例终末期肺病患者通过直升机成功转运至移植单元的案例,转运过程中使用了高流量氧气管,且未出现重大并发症。我们成功的病例报告提出了一种可能性,即在航空医疗转运期间,高流量鼻导管可能可安全用于特定患者群体呼吸衰竭的管理。