Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Ann Card Anaesth. 2023 Oct-Dec;26(4):458-460. doi: 10.4103/aca.aca_11_23.
WATCHMAN is a percutaneous left atrial appendage closure device that is implanted in patients who are unsuitable for anticoagulation therapy for atrial fibrillation. During WATCHMAN implantation, inducing apnea in the patient is preferable to allow stable deployment. We present three cases in which apneic oxygenation was employed to maintain oxygenation during apnea, and oxygen reserve index (ORi) was measured to evaluate its safety and efficacy. Oxygen was administered continuously via the endotracheal tube during apnea. During all four apneic events in three patients (mean duration of 356 seconds), the ORi values maintained above 0.24, which is generally considered the threshold of partial pressure of arterial oxygen (PaO) > 100 mmHg. Transcutaneous oxygen saturation and PaO remained above 99% and 300 mmHg, respectively. There were no respiratory or circulatory complications during or after the surgery.
WATCHMAN 是一种经皮左心耳封堵装置，适用于不适合接受抗凝治疗的房颤患者。在 WATCHMAN 植入过程中，使患者发生呼吸暂停以便于稳定展开封堵器是可取的。我们报告了三例使用呼吸暂停时给氧来维持氧合的病例，并测量了氧储备指数（ORi）来评估其安全性和有效性。在呼吸暂停期间，通过气管内管持续供氧。在三名患者的四次呼吸暂停事件中（平均持续时间 356 秒），ORi 值均维持在 0.24 以上，这通常被认为是动脉血氧分压（PaO）>100mmHg 的阈值。经皮血氧饱和度和 PaO 分别维持在 99%和 300mmHg 以上。手术过程中和手术后均无呼吸或循环并发症。
