Scheck P A, Mallios C
Crit Care Med. 1984 Sep;12(9):803-5. doi: 10.1097/00003246-198409000-00028.
Peroral endoscopies and elective or emergency surgery must often be performed in the airway of patients in poor physical condition. This retrospective review of 600 patients undergoing various surgical procedures found that 194 were ASA physical status groups III or IV, with various abnormalities affecting the cardiorespiratory or central and peripheral nervous systems. These patients received iv anesthesia using short-acting drugs, to guarantee rapid postoperative recovery. All were intraoperatively ventilated with either high-frequency positive-pressure ventilation or high-frequency jet ventilation. Both techniques proved effective, even in patients with upper airway obstruction. In combination with CO2 laser removal of tumors of the glottic region, high-frequency ventilation may prevent the need for emergency tracheotomies.
经口内镜检查以及择期或急诊手术常常必须在身体状况较差的患者气道中进行。这项对600例接受各种外科手术的患者的回顾性研究发现，194例为美国麻醉医师协会（ASA）身体状况分组III或IV级，存在影响心肺或中枢及周围神经系统的各种异常情况。这些患者使用短效药物进行静脉麻醉，以确保术后快速恢复。所有患者术中均采用高频正压通气或高频喷射通气进行通气。这两种技术均证明有效，即使在上气道梗阻的患者中也是如此。与二氧化碳激光切除声门区肿瘤相结合，高频通气可能避免急诊气管切开术的需要。
