配备呼气末正压通气阀简易呼吸器在严重低氧血症患者院内转运中的应用

Application of Portable Breather Valve Respirator with PEEP Valve on Oxygenation in Patients with Severe Hypoxemia during Inhospital Transport

目的观察严重低氧血症患者应用配备呼气末正压通气(PEEP)阀简易呼吸器进行院内转运的有效性与安全性。方法选择2011年7月—2012年3月我院急诊抢救室与急诊ICU收治的严重低氧血症且需院内转运的69例进行前瞻性研究,随机将其分为配备PEEP阀简易呼吸器转运组(PEEP呼吸器组)和传统呼吸器转运组(传统呼吸器组),观察并比较两组切换呼吸支持方式2 min后及转运过程中血氧饱和度(SaO2)变化,同时记录两组转运准备时间。结果切换呼吸支持方式2 min后及转运过程中SaO2水平,PEEP呼吸器组分别为0.980±0.014和0.973±0.012,传统呼吸器组分别为0.953±0.022和0.951±0.024,相应时间点比较PEEP呼吸器组均高于传统呼吸器组,差异均有统计学意义(P<0.05)。切换呼吸支持方式2 min后及转运过程中SaO2水平,PEEP呼吸器组均高于转运前,差异均有统计学意义(P<0.05);传统呼吸器组均低于转运前但差异均无统计学意义(P>0.05)。转运准备时间PEEP呼吸器组为(2.1±0.5)min,传统呼吸器组为(5.5±1.3)min,差异具有统计学意义(P<0.05)。结论严重低氧血症患者应用配备PEEP阀简易呼吸器进行院内转运安全、有效,且较应用传统简易呼吸器转运更为便捷。

Objective To investigate effect and safety of portable breather valve respirator with PEEP valve on oxygenation in patients with severe hypoxemia during inhospital transport. Methods 69 patients with severe hypoxemia who needed inhospital transpert during July 2011 and March 2012 in the resuscitation room and emergency intensive care unit （EICU） in our hospital were prospec- tively investigated and randomly divided into 2 groups： portable breather valve respirator with PEEP valve group （group A） and traditional transpert ventilator group （ group B）. Saturation of blood oxygen （ SaO2 ） in the two groups 2 min after breathing support ways were switched and during transport process were observed and compared. Set up time of transport of the two groups were also recorded at the same time. Results The levels of SaO2 in group A 2 min after breathing support ways were switched and during transport process were 0.980±0.014 and 0.973 ±0.012, while in group B they were 0.953 ± 0.022 and 0.951 ± 0.024. The levels of SaO2 in group A were significantly higher than those in group B at corresponding time （P 〈 0.05）. The levels of SaO2 in group A 2 min after breathing support ways were switched and during transport process were significantly higher than those before transport （P 〈0.05）; while in group B the differences were of no statistical significance （P 〉0.05）. The preparing time in group A was 2. 1 ± 0.5 min while it was 5.5 ± 1.3 min in group B （P 〈 0. 05）. Conclusion Bag valve ventilation with PEEP valve can be used effectively and safely as transport ventilator for patients with severe hypoxemia. It is more convenient than the traditional transport ventilator.