高频-常频程序喷射通气时喷射导管前端位置对血二氧化碳清除效果的影响

Abstract
Figure/Table
References (0)
Related Citation (0)

Download: PDF (1584 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To compare the effect of carbon dioxide elimination during high-conventional frequency jet ventilation with different injector positions in trachea. Methods: Twenty patients undergoing scheduled surgery were selected in this study, with exclusion of thoracic or laparoscopic surgery. High-conventional frequency jet ventilation was applied after general anesthesia. The study objects were randomly divided into two groups named group A and group B by crossover design. In group A, the injection catheter tip was first placed in the endotracheal tube about 3 cm above carina for 40 minutes applying high-conventional frequency jet ventilation, then the injection catheter tip was placed proximal to vocal cord level for another 40 minutes for the same. After that, IPPV was carried out to the end of the surgery. In group B, the only difference is that the injection catheter tip placement sequence was opposite to group A. PETCO2, PIP, MAP, HR, SpO2 and the results of blood gas analysis were recorded at three defined time points including the time before jet ventilation (T0), 20 minutes after jet ventilation (T1), 40 minutes after jet ventilation (T2). Results: The value of PETCO2 at T2 and T1 was significantly higher than that at T0 (P<0.05), and the value at T2 was significantly higher than that at T1 (P<0.05) when the injector head was placed about 3 cm above carina. While the value of PETCO2 at T2 and T1 was significantly lower than that at T0 (P<0.05) when the injector tip was located proximal to the vocal cord level. Placement sequences of injection catheter tip in these two groups made no statistical differences in values of d-PaCO2 (P>0.05), d-PaO2 (P>0.05), d-PH (P>0.05), d-HCO3- (P>0.05). However, there were significant differences in d-PaCO2
(P<0.01), d-PH (P<0.01), d-HCO3- (P<0.01). Conclusion: It is easier to eliminate carbon dioxide in blood when the injector tip was located proximal to the vocal cord level than that was placed about 3 cm above carina where the level of carbon dioxide in blood increased during the high-conventional frequency jet ventilation.

Key words： jet ventilation jet position carbon dioxide

Received: 25 April 2016

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHOU Yamei
	LIU Le
	CHEN Limei
	XU Xuzhong.

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2017/V47/I1/37

[1] DENYS A, LACHENAL Y, DURAN R, et al. Use of high-frequency jet ventilation for percutaneous tumor ablation[J]. Cardiovasc Intervent Radiol, 2014, 37(1): 140-146.
[2] PENG J, YE J, ZHAO Y, et al. Supraglottic jet venlation in ifferent airway management[J]. J Emerg Med, 2012, 43(2): 382-390.
[3] RETTIG J S, SMALLWOOD C D, WALSH B K, et al. High-frequency oscillatory ventilation in pediatric acute lung injury: A multicenter international experience[J]. Crit Care Med, 2015, 43(12): 2660-2667.
[4] RAITEN J, ELKASSABANY N, MANDEL J E. The use of igh-frequency jet ventilation for out of operating room anesthesia[J]. Curr Opin Anaesthesiol, 2012, 25(4): 482-485.
[5] 林春水, 宋远琴. 气管导管远近端复合高频喷射通气对二氧化碳清除和血流动力影响的比较[J]. 中华麻醉学杂志, 1995, 15(1): 15-17.
[6] SPACKMAN D R, KELLOW N, WHITE S A, et al. High frequency jet ventilation and gas trapping[J]. Br J Anaesth,1999, 83 (5): 708-714.
[7] KERN M, NIEMEYER D, KERNER T, et al. Anesthesia in interventional pulmonology bronchoscopy and jet ventilation [J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2015, 50(1): 8-18.
[8] PATHAK V, WELSBY I, MAHMOOD K, et al. Ventilation and anesthetic approaches for rigid bronchoscopy[J]. Ann Am Thorac Soc, 2014, 11(4): 628-634.
[9] 孙喜庆. 高频喷射通气二氧化碳排除效应的影响因素[J].临床荟萃, 1993, (21): 961-962.
[10] 周筱云, 蒋仲荪, 蔡孔长, 等. 高频振荡通气与高频喷射通气对家兔血气水平的影响[J]. 温州医学院学报, 1990(1): 4-7.
[11] BIRO P. Jet ventilation for surgical interventions in the upper airway[J]. Anesthesiol Clin, 2010, 28(3): 397-409.
[12] 季勇, 黄亮, 李闽云, 等. 高频程序通气对心肺复苏呼吸支持作用的临[J]. 中国急救医学, 2009, 29(9): 772-775.
[13] LEITER R, ALIVERTI A, PRIORI R, et al. Comparison of superimposed high-frequency jet ventilation with conventional jet ventilation for laryngeal surgery[J]. Br J Anaesth, 2012, 108(4): 690-697.
[14] REZAIE-MAJD A, BIGENZAHN W, DENK D M, et al. Superimposed high-frequency jet ventilation (SHFJV) for endoscopic laryngotracheal surgery in more than 1500 patients[J]. Br J Anaesth, 2006, 96(5): 650-659.
[15] IHRA G, HIEBER C, SCHABERNIG C, et al. Supralaryngeal tubeless combined high-frequency jet ventilation for laser surgery of the larynx and trachea[J]. Br J Anaesth, 1999, 83(6): 940-942.
[16] IHRA G, ALOY A. On the use of Venturi’s principle to describe entrainment during jet ventilation[J]. J Clin Anesth, 2000, 12(5): 417-419.
[17] LAMPLAND A L, MAMMEL M C. The role of high-frequency ventilation in neonates: evidence-based recommendations[J]. Clin Perinatol, 2007, 34(1): 129-144.