UNASSIGNED: Seventy-two patients undergoing RSI for emergency laparotomy were randomly allocated to either receive pre-oxygenation with 5 L/min of oxygen (O2) with a facemask (Group-FM) or apnoeic oxygenation with 10 L/min of O2 through a nasal catheter in addition to pre-oxygenation (Group-NC). Apnoea (90 s) was allowed from the removal of the facemask before the resumption of ventilation. Arterial blood gas analysis was done at the baseline, following pre-oxygenation and after 90 s of apnoea to study the PaO2 and partial pressure of carbon dioxide (PaCO2). The circuit O2 concentrations (fraction of inspired [FiO2] and end-tidal [EtO2]) were also noted to ensure a steady state of O2 uptake was reached.
UNASSIGNED: The circuit O2 concentrations were 90 ± 4% in group FM and 93 ± 5% in Group-NC. The FiO2-EtO2 difference was 4% in both groups. During the 90 s apnoea following pre-oxygenation, there was a fall in the PaO2 by 38% in Group-FM and 12% in Group-NC (P = 0.000). Increase in PaCO2 was similar in both groups (Group-FM: 44 [range: 32-55] mmHg; Group-NC: 42 [range: 33-54] mmHg, P = 0.809).
UNASSIGNED: Apnoeic insufflation of O2 using a nasopharyngeal catheter along with facemask oxygenation is more effective in sustaining PaO2 for 90 s during RSI than facemask-only oxygenation in patients undergoing emergency laparotomy.
■72例接受RSI急诊剖腹手术的患者被随机分配到使用面罩以5L/min的氧气(O2)进行预充氧(组FM)或除预充氧(组NC)外,通过鼻导管以10L/min的O2进行呼吸氧合。在恢复通气之前,允许从面罩的移除中去除呼吸暂停(90s)。在基线时进行动脉血气分析,在预充氧和90s呼吸暂停后,研究PaO2和二氧化碳分压(PaCO2)。还注意到回路O2浓度(吸入[FiO2]和潮气末[EtO2]的分数),以确保达到O2吸收的稳态。
■电路O2浓度在FM组为90±4%,在NC组为93±5%。两组的FiO2-EtO2差异为4%。在预充氧后的90年代呼吸暂停期间,FM组和NC组PaO2分别下降38%和12%(P=0.000).两组的PaCO2增加相似(FM组:44[范围:32-55]mmHg;NC组:42[范围:33-54]mmHg,P=0.809)。
■在接受紧急剖腹手术的患者中,在RSI期间,使用鼻咽导管和面罩氧合对O2的窒息性吹入比单纯面罩氧合更有效。