Dalens B, Labbe A, Haberer J P, Vanneuville G
Cah Anesthesiol. 1984 Nov;32(7):557-61.
The authors report an original procedure for respiratory assistance during flexible bronchoscopy in infants and toddlers. The injector is directly connected with the operating channel of the bronchoscope. Ventilation parameters are pre-regulated before introducing the fiberscope into the respiratory tree. Insufflation volumes are restricted to 5 ml/kg at the tip of the bronchoscope, on a basis of 40 to 60 cycles per minute, according to children's age. A venturi effect may occur as discrepancy between bronchi and the size of the fiberscope does exist. For evaluating this effect, gas flow is measured through tracheal tubes selected in accordance to the size of the respiratory tree of the infant. This evaluation demonstrates that tidal volumes are comprised within 5 and 10 ml/kg. The procedure of jet-ventilation was performed on 100 infants under general anaesthesia with curarization. Baro-traumatic accidents did not occur, despite poor physical conditions in many cases. The procedure was safe for the infants and convenient for the physicians. In this way, it could be recommended for flexible bronchoscopy in infants and toddlers with poor condition or when excessive duration of the examination could be required (diagnostic or therapeutic procedures associated).
作者报告了一种针对婴幼儿在可弯曲支气管镜检查期间进行呼吸辅助的原创方法。注射器直接与支气管镜的操作通道相连。在将纤维支气管镜插入呼吸道之前,先对通气参数进行预调节。根据儿童年龄,支气管镜尖端的吹入气量限制为5毫升/千克,每分钟40至60次循环。由于支气管与纤维支气管镜的尺寸确实存在差异,可能会出现文丘里效应。为评估这种效应,通过根据婴儿呼吸道树大小选择的气管导管来测量气流。该评估表明潮气量在5至10毫升/千克之间。对100例接受全身麻醉并使用箭毒化的婴儿进行了喷射通气操作。尽管在许多情况下身体状况不佳,但并未发生气压伤事故。该方法对婴儿安全且对医生方便。因此,对于病情较差的婴幼儿或在可能需要较长检查时间(相关诊断或治疗程序)时的可弯曲支气管镜检查,推荐使用该方法。