心搏骤停患者气道管理的研究进展  

Research advance on airway management of patients with cardiac arrest

作　　者：李瑞萍[1] 薛富善[1] 刘高谱 孙超[1] 杨桂珍[1] 

机构地区：[1]中国医学科学院北京协和医学院,整形外科医院麻醉科,100144

出　　处：《国际麻醉学与复苏杂志》2015年第11期1006-1011,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：背景对心搏骤停的生理研究已经使人们对气道（airway）、呼吸（breathing）和循环（circulation）即ABC复苏三步骤的顺序进行了调整。目的综述心搏骤停患者的气道管理问题。内容包括紧急气道管理模式的转变、气道管理的方法和通气管理策略等。特别强调紧急气道管理的最初目标是保证有效通气。在复苏的最初几分钟内，应用简易呼吸囊-面罩（bag-valve-mask，BVM）或声门上气道装置即足以达到此目标，高级气道管理应推迟至3个胸部按压循环后实施。再者，复苏患者通气支持的目标是应用尽可能低的呼气末正压通气（positiveendexpiratorypressure，PEEP），同时调定吸入氧浓度避免高氧。趋向心搏骤停生理研究产生的治疗模式转变全面地改变了相关复苏处理策略。这些改变有望改善心搏骤停患者复苏的结果。Background Recent discoveries surrounding the physiology of cardiac arrest have turned the ABC mnemonic around. Objective This review will focus on issues regarding airway management in patients with cardiac arrest. Content The main contents include the paradigm shifts in emergency airway management, airway management methods, ventilatory management strategies, etc. It is specially emphasized that the initial goal of emergency airway management is the provision of effective ventilation, and can be achieved with a bag-valve-mask （ BVM ） or supraglottic airway device in the first few minutes of resuscitation. The deployment of an advanced airway should be deferred until the completion of 3 chest compression cycles. Furthermore, the goals of ventilator support of the resuscitated patients include the need to use the lowest possiblepositive end expiratory pressure（PEEP） while carefully titrating inspiratory oxygen concernation to avoid hyperoxia. Trend Paradigm shifts by the understanding of cardiac arrest physiology have resulted in changes to overall management strategies of the resuscitated patients. It is hopeful that these changes would improve the outcomes of patients resuscitated from cardiac arrest.

关 键 词：心搏骤停 心脑复苏 气道管理 

分 类 号：R614[医药卫生—麻醉学]