Jungck E, Klöss T
Anasth Intensivther Notfallmed. 1982 Jun;17(3):135-8.
Conventional methods for the replacement of nasotracheal tubes are often dangerous. The interruption of respiration while replacing the nasotracheal airway may cause severe hypoxia. We developed a technique which shortens the time of apnoe to a few seconds. A 16F nasogastric tube is connected to a simple jet ventilation device driven by 100% oxygen. The nasotracheal tube is disconnected from the respirator and its cuff deflated. While performing jet ventilation (inspiration time 1.5 sec, frequency 12/min., pressure 1.5-2 bar) the nasogastric tube is threaded into the nasotracheal tube until the tip lies inside its distal end. The old endotracheal tube can now be retracted over the nasogastric tube under continuous jet ventilation. The nasogastric tube need only be disconnected from the jet ventilator for a few seconds while the old endotracheal tube is replaced for a new one. Now the new endotracheal tube is guided into the trachea by the nasogastic tube while jet ventilation is continued. We used this technique 19 times without any complications. We found the method safe and simple, giving sufficient ventilation in all patients, provided that contraindications and precautions are observed.
传统的更换鼻气管导管的方法通常很危险。更换鼻气管气道时呼吸中断可能会导致严重缺氧。我们开发了一种技术，可将呼吸暂停时间缩短至几秒。将一根16F鼻胃管连接到由100%氧气驱动的简易喷射通气装置上。将鼻气管导管与呼吸机断开连接并放气其套囊。在进行喷射通气时（吸气时间1.5秒，频率12次/分钟，压力1.5 - 2巴），将鼻胃管插入鼻气管导管，直至其尖端位于鼻气管导管远端内部。现在，在持续喷射通气的情况下，可将旧的气管导管沿鼻胃管撤回。在更换新的气管导管时，鼻胃管只需与喷射通气装置断开连接几秒钟。现在，在持续喷射通气的同时，通过鼻胃管将新的气管导管插入气管。我们使用该技术19次，未出现任何并发症。我们发现该方法安全简单，只要遵守禁忌证和注意事项，可为所有患者提供足够的通气。
