无创动态呼吸监测仪在全麻插管患者气道管理中的应用

Application of non-invasive respiratory volume monitor in airway management of patients undergoing general anesthesia with tracheal intubation

目的:探讨无创动态呼吸监测仪在气管内全麻患者气道管理中的应用。方法:行择期手术气管内全麻患者60例,ASAⅠ~Ⅱ级,年龄18~75岁,随机分为呼气末二氧化碳分压监测组(PETCO2组,30例)和无创动态呼吸监测仪组(RVM组,30例)。两组患者均在全麻诱导完成后手术开始前,模拟临床管道脱落情况脱开呼吸回路90 s,记录两组患者开始光标和声音报警时间、回路脱开前后的SpO2、PaO2、PaCO2。结果:两组患者光标报警时间、回路脱开前后的SpO2、PaO2和PaCO2差异均无统计学意义(P>0.05)。RVM组的声音报警时间长于PETCO2组(P<0.05)。结论:无创动态呼吸监测仪可在短时间内发现全麻患者术中呼吸回路断开并出现声光报警,可提供实时的肺通气量数据,明显增加全麻插管患者术中气道管理方面的安全性。

Objective :To investigate the application of non-invasive respiratory volume monitor providing continuousmeasurement(TV,RR,MV)in airway management of patients undergoing general anesthesia with tracheal intubation.Methods:Sixty patients(ASA grade Ⅰ or Ⅱ,age range from 18 to 75 years old)following selective surgery undergoing gen-eral anesthesia with tracheal intubation were selected in this study and randomly divided into 2 groups,including partialpressure of end-tidal group(group PETCO2)and non-invasive respiratory volume monitor group(group RVM). The breath-ing circuits were broken off for 90 s prior to the surgery according to clinical condition. Respiratory volume monitoring da-ta,partial pressure of end-tidal CO(2 PETCO2),PaO2,and PaCO2 between previous disconnection and in advance of it inboth groups were analyzed. In addition,the light and audible time to alarm in PETCO2 group and in RVM group were re-corded.Results :The ligh time to alarm,SpO2,PaO2 and PaCO2 between previous disconnection and in advance of it inboth groups had no significant difference(P>0. 05). The audible time of RVM group was longer than PETCO2 group(P<0. 05).Conclusion:The non-invasive respiratory volume monitor can detect the breathing circuit falls off in a short peri-od of time during general anesthesia with generates audible and visual alarms. It can also provide real-time lung ventilationdata which can significantly enhance the safety of airway management in the operation of general anesthesia patients with tra-cheal intubation.