机械通气在急诊危重症抢救中的应用

Application of Mechanical Ventilation in Critically Ill Emergency Rescue

摘要: 目的：总结积极机械通气在急诊抢救室的危重症救治中应用的经验，提高整体急救水平。方法：回顾性分析我院76例急诊机械通气抢救危重病人的资料。结果：76例急诊机械通气中，63例为一次插管成功，给予机械通气，成功率为82.9%；13例为二次插管后成功，机械通气，插管时间 < 5 min。5例中毒予以气管插管，成功建立人工通气后，机械通气，经进一步抢救全部存活；11例重型颅脑损伤的病人行机械通气后，安全转运至专科治疗，2例死于脑疝；42例猝死患者中，机械通气后10例未能恢复有效循环死亡，2例溺水患者和6例不明原因呼吸心搏骤停患者，行机械通气后抢救无效死亡，慢性阻塞性肺病6例，急性左心衰4例均机械通气后收入ICU继续抢救。结论：机械通气是抢救急诊危重病人的关键性步骤之一，对保证进一步心肺脑复苏，提高危重患者抢救成功率有重要作用和意义。 Objective: To summarize the positive mechanical ventilation in the emergency department treatment of critically ill patients experience applied to improve the overall level of aid. Methods: 76 cases in our hospital emergency rescue of critically ill patients through mechanical ventilation are retrospectively analyzed. Results: In 76 cases of patients undergoing emergency mechanical ventilation, 63 cases are of one-time successful intubation, and the success rate was 82.9%; 13 cases are secondary success, and mechanical ventilation, intubation time < 5 min. 5 cases were given trachea cannula, and after successfully establishing artificial ventilation and mechanical ventilation, all survived with further rescue; 11 cases of severe head injury patients underwent mechanical ventilation, and then they were safe to transport to specialist treatment, and 2 patients died of cerebral hernia. 42 cases of sudden death in patients with mechanical ventilation included: 10 cases failed to restore effective circulating, 2 cases of drowning, 6 patients with unexplained respiratory cardiac arrest after mechanical ventilation, 6 cases of chronic obstructive pulmonary disease, and 4 cases of acute failure of left heart sent to the ICU after mechanical ventilation for continuing rescue. Conclusion: Mechanical ventilation is one of the crucial steps in critically ill patients’ emergency rescue, and it plays an important role in ensuring further cardiopulmonary resuscitation and improving the survival rate of critically ill patients.