Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the curre...Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the current pandemic.Critically ill patients often undergo extracorporeal membrane oxygenation(ECMO)therapy as the last resort over an extended period.ECMO therapy requires sedation of the patient,which is usually achieved by intravenous administration of sedatives.The shortage of intravenous sedative drugs due to the ongoing pandemic,and attempts to improve treatment outcome for COVID-19 patients,drove the application of inhaled sedation as a promising alternative for sedation during ECMO therapy.Administration of volatile anesthetics requires an appropriate delivery.Commercially available ones are the anesthetic gas reflection systems AnaConDa®and MIRUSTM,and each should be combined with a gas scavenging system.In this review,we describe respiratory management in COVID-19 patients and the procedures for inhaled sedation during ECMO therapy of COVID-19 related ARDS.We focus particularly on the technical details of administration of volatile anesthetics.Furthermore,we describe the advantages of inhaled sedation and volatile anesthetics,and we discuss the limitations as well as the requirements for safe application in the clinical setting.展开更多
目的探讨盐酸纳美芬对老年患者腹部手术麻醉后呼吸抑制的影响。方法将156例2015年1月至2016年12月在我院接受腹部手术的老年患者纳入课题研究,分为实验组和对照组两组(n=78),分组方法为随机数字表法。手术结束后实验组患者静脉推注0.25...目的探讨盐酸纳美芬对老年患者腹部手术麻醉后呼吸抑制的影响。方法将156例2015年1月至2016年12月在我院接受腹部手术的老年患者纳入课题研究,分为实验组和对照组两组(n=78),分组方法为随机数字表法。手术结束后实验组患者静脉推注0.25μg/kg盐酸纳美芬;对照组患者静脉推注1μg/kg的盐酸纳洛酮。结果两组患者拔管后5min Ramsay评分和拔管后30 min VAS评分比较,差异无统计学意义,P>0.05;两组患者的不同时间点收缩压、舒张压、平均动脉压以及心率等各项指标的变化均无统计学意义,P>0.05;实验组和对照组患者的拔管时间分别(5.61±0.42)min和(5.73±0.56)min,差异无统计学意义,t=1.514,P>0.05;实验组患者给予拮抗药10 min后呼吸恢复率为96.15%,显著高于对照组的87.18%,P<0.05;两组患者不良反应发生率差异无统计学意义,P>0.05。结论盐酸纳美芬能够有效拮抗老年患者腹部手术麻醉后呼吸抑制。展开更多
文摘Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the current pandemic.Critically ill patients often undergo extracorporeal membrane oxygenation(ECMO)therapy as the last resort over an extended period.ECMO therapy requires sedation of the patient,which is usually achieved by intravenous administration of sedatives.The shortage of intravenous sedative drugs due to the ongoing pandemic,and attempts to improve treatment outcome for COVID-19 patients,drove the application of inhaled sedation as a promising alternative for sedation during ECMO therapy.Administration of volatile anesthetics requires an appropriate delivery.Commercially available ones are the anesthetic gas reflection systems AnaConDa®and MIRUSTM,and each should be combined with a gas scavenging system.In this review,we describe respiratory management in COVID-19 patients and the procedures for inhaled sedation during ECMO therapy of COVID-19 related ARDS.We focus particularly on the technical details of administration of volatile anesthetics.Furthermore,we describe the advantages of inhaled sedation and volatile anesthetics,and we discuss the limitations as well as the requirements for safe application in the clinical setting.
文摘目的探讨盐酸纳美芬对老年患者腹部手术麻醉后呼吸抑制的影响。方法将156例2015年1月至2016年12月在我院接受腹部手术的老年患者纳入课题研究,分为实验组和对照组两组(n=78),分组方法为随机数字表法。手术结束后实验组患者静脉推注0.25μg/kg盐酸纳美芬;对照组患者静脉推注1μg/kg的盐酸纳洛酮。结果两组患者拔管后5min Ramsay评分和拔管后30 min VAS评分比较,差异无统计学意义,P>0.05;两组患者的不同时间点收缩压、舒张压、平均动脉压以及心率等各项指标的变化均无统计学意义,P>0.05;实验组和对照组患者的拔管时间分别(5.61±0.42)min和(5.73±0.56)min,差异无统计学意义,t=1.514,P>0.05;实验组患者给予拮抗药10 min后呼吸恢复率为96.15%,显著高于对照组的87.18%,P<0.05;两组患者不良反应发生率差异无统计学意义,P>0.05。结论盐酸纳美芬能够有效拮抗老年患者腹部手术麻醉后呼吸抑制。
