tailieunhanh - Báo cáo y học: " Pharyngeal oxygen administration increases the time to serious desaturation at intubation in acute lung injury: an experimental study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Pharyngeal oxygen administration increases the time to serious desaturation at intubation in acute lung injury: an experimental study. | Engstrom et al. Critical Care 2010 14 R93 http content 14 3 R93 RESEARCH Open Access Pharyngeal oxygen administration increases the time to serious desaturation at intubation in acute lung injury an experimental study Joakim Engstrom1 Goran Hedenstierna2 and Anders Larsson 3 Abstract Introduction Endotracheal intubation in critically ill patients is associated with severe life-threatening complications in about 20 mainly due to hypoxemia. We hypothesized that apneic oxygenation via a pharyngeal catheter during the endotracheal intubation procedure would prevent or increase the time to life-threatening hypoxemia and tested this hypothesis in an acute lung injury animal model. Methods Eight anesthetized piglets with collapse-prone lungs induced by lung lavage were ventilated with a fraction of inspired oxygen of and a positive end-expiratory pressure of 5 cmH2O. The shunt fraction was calculated after obtaining arterial and mixed venous blood gases. The trachea was extubated and in randomized order each animal received either 10 L oxygen per minute or no oxygen via a pharyngeal catheter and the time to desaturation to pulse oximeter saturation SpO2 60 was measured. If SpO2 was maintained at over 60 the experiment ended when 10 minutes had elapsed. Results Without pharyngeal oxygen the animals desaturated after 103 88-111 seconds median and interquartile range whereas with pharyngeal oxygen five animals had a SpO2 60 for the 10-minute experimental period one animal desaturated after 7 minutes and two animals desaturated within 90 seconds P Wilcoxon signed rank test . The time to desaturation was related to shunt fraction R2 P linear regression the animals that desaturated within 90 seconds had shunt fractions 40 whereas the others had shunt fractions 25 . Conclusions In this experimental acute lung injury model pharyngeal oxygen administration markedly prolonged the time to severe desaturation during apnea suggesting that this .