Barbosa Alexandra, Mosier Jarrod M
Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA.
Division of Pulmonary, Allergy, Critical Care, and Sleep, Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA.
Clin Exp Emerg Med. 2024 Jun;11(2):136-144. doi: 10.15441/ceem.23.089. Epub 2024 Jan 29.
Preoxygenation during the peri-intubation period is now considered a critical aspect of rapid sequence intubation and an important skill for emergency medicine and critical care providers. Peri-intubation hypoxemia carries significant risk, including cardiac arrest, and care must be taken for appropriate management including through apnea and initiation of laryngoscopy. Appropriate selection of preoxygenation devices should depend on underlying physiology to optimize oxygenation prior to intubation attempts. A PubMed MEDLINE search was completed with selection of articles from March 2008 to March 2023 describing various techniques for preoxygenation for intubation in the critical care and operating room setting with pregnant and obese patient populations included. Prehospital and pediatric populations were excluded in this review. This review provides an overview of methods of preoxygenation with their clinical indications as well as methods for determining end points to preoxygenation and apneic oxygenation. An overview of approaches to preoxygenation was included for patients considered to have a physiologically difficult airway and obese and pregnant patient populations.
围插管期预给氧现已被视为快速顺序插管的关键环节，也是急诊医学和重症护理人员的一项重要技能。围插管期低氧血症存在重大风险，包括心脏骤停，必须谨慎进行适当管理，包括通过暂停呼吸和开始喉镜检查。预给氧设备的适当选择应取决于基础生理学情况，以便在尝试插管前优化氧合。通过检索PubMed MEDLINE，选取了2008年3月至2023年3月期间描述重症监护和手术室环境中针对包括孕妇和肥胖患者群体在内的插管预给氧各种技术的文章。本综述排除了院前和儿科人群。本综述概述了预给氧方法及其临床适应证，以及确定预给氧和无呼吸氧合终点的方法。还纳入了针对被认为气道生理情况复杂的患者以及肥胖和孕妇群体的预给氧方法概述。
