成年人非心胸手术中通气管理的临床实践:一项全国问卷调查研究  

Clinical practice of intraoperative ventilation management in non‑cardiothoracic surgery:a national questionnaire survey in China

作　　者：饶倩倩 玉红[1] 王思洋 余海[1] Rao Qianqian;Yu Hong;Wang Siyang;Yu Hai(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]复旦大学中山医院麻醉科,上海200032

出　　处：《国际麻醉学与复苏杂志》2024年第2期168-173,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的调查中国麻醉医师在成年人非心胸手术中通气管理的临床实践现状。方法2021年8月至2021年9月,向中国81家大型三甲综合医院麻醉科发出电子调查问卷进行全国调查性研究,分析小潮气量(V_(T))通气、呼气末正压通气(PEEP)及肺复张手法(ARM)的应用情况和“肺保护性通气(LPV)策略”的理论认识情况。对调查结果进行描述性统计分析。结果全国57家调查中心参与调查,调查中心回复率为70%,回收有效问卷1089份。92.7%的麻醉医师术中常规使用小VT通气。77.1%的麻醉医师术中常规设置PEEP,1~5 cmH_(2)O(1 cmH_(2)O=0.098 kPa)是最常采用的PEEP水平。84.6%的麻醉医师术中常规实施ARM。绝大多数麻醉医师(97.9%)认为“LPV策略”是指联合使用“小V_(T)、PEEP及ARM”。64.8%的麻醉医师术中常规联合使用小V_(T)、PEEP及ARM。结论中国大型三甲综合医院的麻醉医师在成年人非心胸手术中通气管理中的临床实践现状存在异质性,LPV策略的临床实践与理论认识存在一定差距。To investigate the current practice of intraoperative ventilation management during non‑cardiothoracic surgery by Chinese anesthesiologists.Methods From August 2021 to September 2021,we developed an electronic questionnaire and distributed to Department of Anesthesiology of 81 tertiary general hospitals in China,in order to evaluate the application of low tidal volume(V_(T))ventilation,positive end‑expiratory pressure(PEEP)and alveolar recruitment maneuver(ARM)and the understanding of lung‑protective ventilation(LPV)strategy.The results were analyzed for descriptive statistics.Results A total of 57 domestic institutions participated in the survey,with a response rate of 70%,where 1089 valid questionnaires were collected.Notably,92.7%anesthesiologists routinely used low V_(T) ventilation and 77.1%anesthesiologists routinely set PEEP during surgery,where 1‒5 cmH_(2)O(1 cmH_(2)O=0.098 kPa)was most commonly applied for PEEP.Furthermore,84.6%anesthesiologists routinely performed ARM during surgery.Nearly most of the respondents(97.9%)considered that“LPV strategy”refers to the combined use of“low V_(T),PEEP,and ARM”.Also,64.8%of the respondents routinely performed low V_(T),PEEP and ARM in combination.Conclusions There is heterogeneity in clinical practice of ventilation management in adult non‑cardiothoracic surgery among anesthesiologists in China,and there is a gap between the clinical practice and theoretical understanding of LPV strategy.

关 键 词：问卷调查 非心胸手术 机械通气 肺保护性通气策略 

分 类 号：R614[医药卫生—麻醉学]