Stone B J, Chantler P J, Baskett P J
Department of Resuscitation, Conquest Hospital, Hastings, E. Sussex, UK.
Resuscitation. 1998 Jul;38(1):3-6. doi: 10.1016/s0300-9572(98)00068-9.
The risk of gastric regurgitation and subsequent pulmonary aspiration is a recognised complication of cardiac arrest--a risk which may be further increased by the resuscitative procedure itself. The purpose of this study was to compare the incidence of gastric regurgitation between the bag valve mask (BVM) and laryngeal mask airway (LMA). The resuscitation data collection forms of 996 patients who underwent in-hospital cardiopulmonary resuscitation over a 3.5 year period were reviewed. Of these, 199 patients were excluded from the study because there was no airway management involving a BVM or LMA. The incidence and timing of regurgitation was studied in the remaining 797 patients. Regurgitation was recorded to have occurred at some stage in 180 of these patients (22.6%). However, 84 regurgitated prior to CPR (46.7% of those patients who regurgitated). These patients were excluded from further analysis as regurgitation could not have been affected by any form of ventilation. Of the remaining 713 patients, BVM ventilation was used in 636 cases. In 170 of these the LMA was also used following the BVM. Where the patient was ventilated with the BVM alone or BVM followed by ETT the incidence of regurgitation during CPR was 12.4%. The LMA was used during resuscitation in 256 cases of which 170 had BVM ventilation prior to the LMA. Where the patient was ventilated with the LMA alone or LMA followed by ETT the incidence of regurgitation during CPR was 3.5%. The study confirms experience reported in earlier studies that when an LMA is used as a first line airway device, regurgitation is relatively uncommon.
胃反流及随后的肺误吸风险是心脏骤停公认的并发症，而复苏操作本身可能会进一步增加这种风险。本研究的目的是比较气囊面罩（BVM）和喉罩气道（LMA）胃反流的发生率。回顾了996例在3.5年期间接受院内心肺复苏患者的复苏数据收集表。其中，199例患者被排除在研究之外，因为没有涉及BVM或LMA的气道管理。在其余797例患者中研究了反流的发生率和时间。记录到其中180例患者（22.6%）在某个阶段发生了反流。然而，84例在心肺复苏之前就发生了反流（占反流患者的46.7%）。这些患者被排除在进一步分析之外，因为反流不可能受到任何形式通气的影响。在其余713例患者中，636例使用了BVM通气。其中170例在使用BVM后还使用了LMA。当患者仅使用BVM通气或先使用BVM再使用气管内导管（ETT）时，心肺复苏期间反流的发生率为12.4%。复苏期间256例使用了LMA，其中170例在使用LMA之前进行了BVM通气。当患者仅使用LMA通气或先使用LMA再使用ETT时，心肺复苏期间反流的发生率为3.5%。该研究证实了早期研究报告的经验，即当LMA用作一线气道装置时，反流相对不常见。
