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Transnasal humidified rapid insufflation ventilatory exchange vs. facemask oxygenation in elderly patients undergoing general anaesthesia: a randomized controlled trial.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-04-01 , DOI: 10.1038/s41598-020-62716-2 Zhen Hua 1 , Zhen Liu 1 , Yang Li 1, 2 , Hongye Zhang 1 , Ming Yang 1 , Mingzhang Zuo 1
Scientific Reports ( IF 3.8 ) Pub Date : 2020-04-01 , DOI: 10.1038/s41598-020-62716-2 Zhen Hua 1 , Zhen Liu 1 , Yang Li 1, 2 , Hongye Zhang 1 , Ming Yang 1 , Mingzhang Zuo 1
Affiliation
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Transnasal humidified rapid insufflation ventilator exchange (THRIVE) may be effective in delaying hypoxia, but the efficacy of THRIVE for oxygenation in elderly patients under general anaesthesia has not been assessed. This study assessed whether THRIVE prolonged the apnoea time in the elderly patients after induction. This was a single centre, two-group, randomized controlled trial. 60 patients (65 to 80 years of age) with American Society of Anesthesiologists (ASA) grades I ~ III who required tracheal intubation or the application of a laryngeal mask under general anaesthesia were randomly allocated to receive oxygenation using THRIVE (100% oxygen, 30~70 litres min-1) or a facemask (100% oxygen, 10 litres min-1) during the pre-oxygenation period and during apnoea. The apnoea time, which was defined as the time from the cessation of spontaneous breathing until the SpO2 decreased to 90% or the apnoea time reached 10 minutes was recorded as the primary outcome. No significant differences were found on the baseline characteristics between the groups. The apnoea time was significantly increased (P < 0.01) in the THRIVE group. The median (interquartile range) apnoea times were 600 (600-600) s in the THRIVE group and 600 (231.5-600) s in the facemask group. No significant differences were found in the PaO2, PaCO2 and vital parameters between the THRIVE and facemask groups. No increased occurrence of complications, including haemodynamic instability, resistant arrhythmia or nasal discomfort, were reported in both the THRIVE group and the facemask group. THRIVE prolongs the apnoea time in elderly patients. THRIVE may be a more effective method for pre-oxygenation than a facemask in the elderly without pulmonary dysfunction.
中文翻译：
经全身麻醉的老年患者经鼻加湿快速通气换气与面罩充氧的比较：一项随机对照试验。
经鼻加湿的快速吹气呼吸机更换（THRIVE）可能在延迟缺氧方面有效，但是尚未评估THRIVE在全身麻醉下对老年患者进行充氧的功效。这项研究评估了THRIVE是否延长了老年患者诱导后的呼吸暂停时间。这是一项单中心，两组，随机对照试验。60例美国麻醉师学会（ASA）I〜III级（年龄在65至80岁之间）在全身麻醉下需要气管插管或应用喉罩的患者被随机分配接受THRIVE（100％氧气，30在预充氧期间和呼吸暂停期间使用〜70升min-1）或面罩（100％氧气，10升min-1）。呼吸暂停时间 主要定义为从停止自发呼吸到SpO2降至90％或呼吸暂停时间达到10分钟为止的时间。两组之间的基线特征没有发现显着差异。THRIVE组的呼吸暂停时间显着增加（P <0.01）。THRIVE组的中位（四分位间距）呼吸暂停时间为600（600-600）s，面罩组为600（231.5-600）s。在THRIVE和面罩组之间，PaO2，PaCO2和生命参数没有显着差异。在THRIVE组和面罩组中，均未发现并发症的发生率增加，包括血流动力学不稳定，抵抗性心律不齐或鼻部不适。THRIVE延长了老年患者的呼吸暂停时间。
更新日期：2020-04-01
中文翻译：
经全身麻醉的老年患者经鼻加湿快速通气换气与面罩充氧的比较：一项随机对照试验。
经鼻加湿的快速吹气呼吸机更换（THRIVE）可能在延迟缺氧方面有效，但是尚未评估THRIVE在全身麻醉下对老年患者进行充氧的功效。这项研究评估了THRIVE是否延长了老年患者诱导后的呼吸暂停时间。这是一项单中心，两组，随机对照试验。60例美国麻醉师学会（ASA）I〜III级（年龄在65至80岁之间）在全身麻醉下需要气管插管或应用喉罩的患者被随机分配接受THRIVE（100％氧气，30在预充氧期间和呼吸暂停期间使用〜70升min-1）或面罩（100％氧气，10升min-1）。呼吸暂停时间 主要定义为从停止自发呼吸到SpO2降至90％或呼吸暂停时间达到10分钟为止的时间。两组之间的基线特征没有发现显着差异。THRIVE组的呼吸暂停时间显着增加（P <0.01）。THRIVE组的中位（四分位间距）呼吸暂停时间为600（600-600）s，面罩组为600（231.5-600）s。在THRIVE和面罩组之间，PaO2，PaCO2和生命参数没有显着差异。在THRIVE组和面罩组中，均未发现并发症的发生率增加，包括血流动力学不稳定，抵抗性心律不齐或鼻部不适。THRIVE延长了老年患者的呼吸暂停时间。
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