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一种新型氧气清除面罩在将局部氧气浓度降低至手术火灾风险阈值以下的效果:一项概念验证实验研究。

Efficacy of a novel oxygen scavenger mask in reducing local oxygen concentrations below the surgical fire risk threshold: an experimental proof-of-concept study.

作者信息

Yang Christopher D, Chen Teresa H, Tao Jeremiah P

机构信息

Division of Oculofacial and Orbital Surgery, Gavin Herbert Eye Institute, Irvine, CA, USA.

UC Irvine Health, Irvine, CA, USA.

出版信息

Patient Saf Surg. 2024 Sep 12;18(1):27. doi: 10.1186/s13037-024-00411-1.

DOI:10.1186/s13037-024-00411-1
PMID:39267129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11391775/
Abstract

BACKGROUND

This study aims to evaluate the efficacy of an oxygen scavenging mask device in reducing local oxygen concentrations from nasal cannula ventilation compared to a standard open facial surgical field.

METHODS

This is a controlled experiment using a custom-fabricated silicone midfacial oxygen scavenging device, SimMan airway management trainer manikin (Laerdal Medical, Stavanger, Norway), handheld oxygen detector (Forensics Detectors, Los Angeles, United States) and oxygen from a Datex Ohmeda Aisys Carestation anesthesia unit (GE HealthCare, Chicago, United States). Oxygen concentrations were measured at 18 facial landmarks (Fig. 1) with nasal cannula flow of 2, 4, and 6 L/min of 100% FiO2 in both masked and unmasked conditions (Fig. 2).

RESULTS

The mean oxygen concentration in the facial surgical field was 20.95% with the scavenger mask and 24.8% without (P < 0.001; two-tailed paired t-test). The unmasked condition was associated with suprathreshold oxygen concentration levels at 13 of 18 facial landmarks (Table 1). The device significantly reduced local oxygen concentration at 16 of 18 facial landmarks (Table 1). The device provided safe oxygen concentration levels at all three flow rates, and measured oxygen concentrations directly correlated with oxygen flow rate in the unmasked condition (Table 2).

CONCLUSIONS

An oxygen scavenger mask device reduced local oxygen concentrations from nasal cannula ventilation to below the 23% fire threshold in the entire facial surgical field external to the mask in these experiments. The device may reduce intraoperative fire risk in patients that require supplementary oxygen during surgery.

摘要

背景

本研究旨在评估一种吸氧面罩装置与标准开放式面部手术视野相比,在降低鼻导管通气时局部氧气浓度方面的效果。

方法

这是一项对照实验,使用定制的硅胶中面部吸氧装置、SimMan气道管理训练模拟人(挪威斯塔万格的Laerdal Medical公司)、手持式氧气探测器(美国洛杉矶的Forensics Detectors公司)以及来自Datex Ohmeda Aisys Carestation麻醉机(美国芝加哥的GE医疗集团)的氧气。在面罩佩戴和未佩戴的情况下,以100%的吸氧浓度,分别设置鼻导管流量为2、4和6L/min,在18个面部标志点(图1)测量氧气浓度(图2)。

结果

使用吸氧面罩时,面部手术视野中的平均氧气浓度为20.95%,未使用时为24.8%(P < 0.001;双侧配对t检验)。在未佩戴面罩的情况下,18个面部标志点中有13个的氧气浓度超过阈值(表1)。该装置使18个面部标志点中的16个的局部氧气浓度显著降低(表1)。该装置在所有三种流量下都提供了安全的氧气浓度水平,并且在未佩戴面罩的情况下,测量的氧气浓度与氧气流量直接相关(表2)。

结论

在这些实验中,吸氧面罩装置将鼻导管通气产生的局部氧气浓度降低至面罩外部整个面部手术视野低于23%的着火阈值。该装置可能会降低手术期间需要补充氧气的患者的术中着火风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/11391775/b3fa73bae6e3/13037_2024_411_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/11391775/a03765d0ef15/13037_2024_411_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/11391775/b3fa73bae6e3/13037_2024_411_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/11391775/a03765d0ef15/13037_2024_411_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/11391775/b3fa73bae6e3/13037_2024_411_Fig2_HTML.jpg

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本文引用的文献

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Sentinel Event Alert 68: Updated Surgical Fire Prevention for the 21st Century.《警示事件警报68:21世纪手术防火最新指南》
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Surgical Fire in the United States: 2000-2020.美国2000 - 2020年手术火灾情况
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Process Saf Environ Prot. 2021 Sep;153:278-288. doi: 10.1016/j.psep.2021.06.023. Epub 2021 Jun 24.
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The Effects of Different Levels of Ambient Oxygen in an Oxygen-Enriched Surgical Environment and Production of Surgical Fires.
Anesth Prog. 2018 Spring;65(1):3-8. doi: 10.2344/anpr-64-04-12.
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Operating room fires in periocular surgery.眼周手术中的手术室火灾
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Operating room fires: a closed claims analysis.手术室火灾:封闭索赔分析。
Anesthesiology. 2013 May;118(5):1133-9. doi: 10.1097/ALN.0b013e31828afa7b.
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The efficacy of a midfacial seal drape in reducing oculofacial surgical field fire risk.一种中面部密封罩在降低眼科手术领域火灾风险方面的效果。
Ophthalmic Plast Reconstr Surg. 2013 Mar-Apr;29(2):109-12. doi: 10.1097/IOP.0b013e31827defe1.
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"Blow-torch phenomenon" during laser assisted excision of a thyroglossal cyst at the base of the tongue.舌根部甲状舌管囊肿激光辅助切除术中的“喷灯现象”
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The Density of Oxygen and Its Compressibility below One Atmosphere: II.低于一个大气压时氧气的密度及其可压缩性:II
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