BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the a...BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxemia during gastroscopy with propofol mono-sedation compared with nasal prongs,but causing slight epistaxis in a few patients.展开更多
声门上喷射供氧通气(supraglottic jet oxygenation and ventilation,SJOV)是一种新型的无创呼吸支持技术,可以为呼吸抑制乃至呼吸暂停的患者提供有效、安全、可靠的供氧和通气,SJOV操作简单,氧合效果好,且无严重并发症。文章综述了SJO...声门上喷射供氧通气(supraglottic jet oxygenation and ventilation,SJOV)是一种新型的无创呼吸支持技术,可以为呼吸抑制乃至呼吸暂停的患者提供有效、安全、可靠的供氧和通气,SJOV操作简单,氧合效果好,且无严重并发症。文章综述了SJOV的设置、临床应用及可能引发的并发症,并与其他氧合通气装置进行了比较。SJOV在喉部手术、支气管镜检查以及困难气道的处理中具有独特优势,并可应用于部分门诊手术和无痛检查,尤其适用于缺氧风险较高的特殊患者。SJOV在更多临床场景的广泛应用,尚有待更多的研究和实践以证实。展开更多
目的观察魏氏鼻咽通气道声门上喷射通气在肥胖患者宫腔镜手术中的临床效果。方法择期全身麻醉下行宫腔镜手术的肥胖患者80例随机分为两组,每组40例。W组置入魏氏鼻咽通气道,行喷射通气;L组插入LMA喉罩,行间歇正压通气。记录麻醉诱导前(...目的观察魏氏鼻咽通气道声门上喷射通气在肥胖患者宫腔镜手术中的临床效果。方法择期全身麻醉下行宫腔镜手术的肥胖患者80例随机分为两组,每组40例。W组置入魏氏鼻咽通气道,行喷射通气;L组插入LMA喉罩,行间歇正压通气。记录麻醉诱导前(T0)、置入鼻咽通气道或喉罩时(T1)、术毕拔出鼻咽通气道或喉罩时(T2)的HR、MAP和SpO_(2)。比较两组建立气道所需时间、术中SpO_(2)<95%和需要气管插管的发生率。观察不良反应发生情况。结果两组T0、T1和T2时的HR、MAP和SpO_(2)均无统计学差异(P>0.05)。与L组比较,W组建立气道所需时间较短[(14.5±3.3) s vs.(30.3±5.2) s](P<0.05),SpO_(2)<95%(2.5%vs.27.5%)和需要气管插管(2.5%vs.22.5%)的发生率较低(P<0.05)。两组术后烦躁、声嘶和鼻咽部不适等的发生率相仿(P>0.05),W组患者胃胀气的发生率低于L组(P<0.05)。结论魏氏鼻咽通气道声门上喷射通气可安全地用于肥胖患者宫腔镜手术中,操作简单,不良反应少。展开更多
基金Supported by“Renfu”Research Fund by Chinese Society of Digestive Endoscopy,No.CSDE012017120006.
文摘BACKGROUND Hypoxemia due to respiratory depression and airway obstruction during upper gastrointestinal endoscopy with sedation is a common concern.The Wei nasal jet tube(WNJT)is a new nasopharyngeal airway with the ability to provide supraglottic jet ventilation and oxygen insufflation via its built-in wall channel.The available evidence indicates that with a low oxygen flow,compared with nasal cannula,the WNJT does not decrease the occurrence of hypoxemia during upper gastrointestinal endoscopy with propofol sedation.To date,there has been no study assessing the performance of WNJT for supplemental oxygen during upper gastrointestinal endoscopy with sedation when a moderate oxygen flow is used.AIM To determine whether the WNJT performs better than the nasal prongs for the prevention of hypoxemia during gastroscopy with propofol mono-sedation when a moderate oxygen flow is provided in patients with a normal body mass index.METHODS This study was performed in 291 patients undergoing elective gastroscopy with propofol mono-sedation.Patients were randomized into one of two groups to receive either the WNJT(WNJT group,n=147)or the nasal cannula(nasal cannula group,n=144)for supplemental oxygen at a 5-L/min flow during gastroscopy.The lowest SpO2 during gastroscopy was recorded.The primary endpoint was the incidence of hypoxemia or severe hypoxemia during gastroscopy.RESULTS The total incidence of hypoxemia and severe hypoxemia during gastroscopy was significantly decreased in the WNJT group compared with the nasal cannula group(P=0.000).The lowest median SpO2 during gastroscopy was significantly higher(98%;interquartile range,97-99)in the WNJT group than in the nasal cannula group(96%;interquartile range,93-98).Epistaxis by device insertion in the WNJT group occurred in 7 patients but stopped naturally without any treatment.The two groups were comparable in terms of the satisfaction of physicians,anesthetists and patients.CONCLUSION With a moderate oxygen flow,the WNJT is more effective for the prevention of hypoxemia during gastroscopy with propofol mono-sedation compared with nasal prongs,but causing slight epistaxis in a few patients.
文摘声门上喷射供氧通气(supraglottic jet oxygenation and ventilation,SJOV)是一种新型的无创呼吸支持技术,可以为呼吸抑制乃至呼吸暂停的患者提供有效、安全、可靠的供氧和通气,SJOV操作简单,氧合效果好,且无严重并发症。文章综述了SJOV的设置、临床应用及可能引发的并发症,并与其他氧合通气装置进行了比较。SJOV在喉部手术、支气管镜检查以及困难气道的处理中具有独特优势,并可应用于部分门诊手术和无痛检查,尤其适用于缺氧风险较高的特殊患者。SJOV在更多临床场景的广泛应用,尚有待更多的研究和实践以证实。
文摘目的观察魏氏鼻咽通气道声门上喷射通气在肥胖患者宫腔镜手术中的临床效果。方法择期全身麻醉下行宫腔镜手术的肥胖患者80例随机分为两组,每组40例。W组置入魏氏鼻咽通气道,行喷射通气;L组插入LMA喉罩,行间歇正压通气。记录麻醉诱导前(T0)、置入鼻咽通气道或喉罩时(T1)、术毕拔出鼻咽通气道或喉罩时(T2)的HR、MAP和SpO_(2)。比较两组建立气道所需时间、术中SpO_(2)<95%和需要气管插管的发生率。观察不良反应发生情况。结果两组T0、T1和T2时的HR、MAP和SpO_(2)均无统计学差异(P>0.05)。与L组比较,W组建立气道所需时间较短[(14.5±3.3) s vs.(30.3±5.2) s](P<0.05),SpO_(2)<95%(2.5%vs.27.5%)和需要气管插管(2.5%vs.22.5%)的发生率较低(P<0.05)。两组术后烦躁、声嘶和鼻咽部不适等的发生率相仿(P>0.05),W组患者胃胀气的发生率低于L组(P<0.05)。结论魏氏鼻咽通气道声门上喷射通气可安全地用于肥胖患者宫腔镜手术中,操作简单,不良反应少。
