Lussi C, Grapengeter M, Schmitz B, Schüttler J
Klinik für Anästhesiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 Nov;33(11):726-9. doi: 10.1055/s-2007-994844.
The loss of pipeline pressure in a central gas supply system is a rare but potentially hazardous complication in anaesthesia and critical care. In an anaesthesia simulator study, reactions of 20 anaesthetists to this simulated critical incident were monitored and evaluated. A comparison between novice (n = 10) and experienced anaesthesia residents/consultants (n = 10) determined a significantly quicker and more on-target reaction by the experienced anaesthetists. Unlike older cycle system anaesthesia machines, update anaesthesia ventilators (CICERO EM, Dräger, Lübeck) do not permit manual ventilation of a patient in a "closed-system" once pipeline pressure drops to zero. In this highly hazardous event, the patient has to be ventilated by reservoir bag until a sufficient back-up system delivering high inspiratory oxygen concentrations can be installed, because he is otherwise prone to diffusion hypoxia. Installation of mandatory (anaesthesia-machine integrated) back-up systems for respirators without cycle systems would therefore increase patient safety. A general algorithm for loss of pipeline pressure can be described only after a back-up system has been installed.
中央供气系统中管道压力丧失是麻醉和重症监护中一种罕见但可能具有危险性的并发症。在一项麻醉模拟器研究中，对20名麻醉医生对这种模拟危急事件的反应进行了监测和评估。通过比较新手（n = 10）和经验丰富的麻醉住院医生/顾问（n = 10）发现，经验丰富的麻醉医生反应明显更快且更切中要害。与老式循环系统麻醉机不同，新型麻醉呼吸机（CICERO EM，德尔格公司，吕贝克）一旦管道压力降至零，就不允许在“封闭系统”中对患者进行手动通气。在这种高度危险的情况下，必须通过储气囊对患者进行通气，直到能够安装提供高吸入氧浓度的足够备用系统，因为否则患者容易发生弥散性缺氧。因此，为无循环系统的呼吸机安装强制性（集成于麻醉机的）备用系统将提高患者安全性。只有在安装备用系统之后，才能描述管道压力丧失的一般算法。
