高频通气在胸科手术中应用研究
Application of High Frequency Ventilation in Thoracic Surgery
DOI: 10.12677/ACM.2024.141223, PDF,   
作者: 刘 乾：西安医学院，陕西 西安；第四军医大学唐都医院麻醉科，陕西 西安；陶 蕾*：第四军医大学唐都医院麻醉科，陕西 西安
关键词: 单肺通气；高频通气；胸科手术；One Lung Ventilation； High Frequency Ventilation； Thoracic Surgery
摘要: 增加单肺通气期间氧合，降低术后肺部并发症的发生率是提高胸科手术麻醉管理质量的基础，通气侧实施肺保护性通气策略可以在一定程度上改善预后，然而非通气侧肺泡持续萎陷造成的肺萎陷伤导致术后肺部并发症增加仍是难以避免的问题。1967年提出的高频通气，在ARDS的救治中广泛使用，能够提高患者氧合，维持肺泡膨胀。有报道，在胸科手术中应用高频通气，可减少术中非通气侧的肺泡萎陷，本文旨在对高频通气在胸科手术中应用的可靠性及局限性进行综述。
Abstract: Increasing oxygenation during one lung ventilation and reducing the incidence of postoperative lung complications are the basis for improving the quality of anesthesia management in thoracic surgery. The implementation of lung protective ventilation strategy on the ventilation side can im-prove the prognosis to a certain extent. However, the increase of postoperative lung complications caused by lung collapse injury caused by continuous collapse of alveoli on the non-ventilation side is still an unavoidable problem. High-frequency ventilation, proposed in 1967, is widely used in the treatment of ARDS, which can improve patient oxygenation and maintain alveolar expansion. It has been reported that the application of high frequency ventilation in thoracic surgery can reduce the collapse of alveoli on the non-ventilated side of the operation. This article aims to review the relia-bility and limitations of the application of high frequency ventilation in thoracic surgery.
文章引用：刘乾, 陶蕾. 高频通气在胸科手术中应用研究[J]. 临床医学进展, 2024, 14(1): 1547-1551. https://doi.org/10.12677/ACM.2024.141223

参考文献

[1] Alday, E., Nieves, J.M. and Planas, A. (2020) Oxygen Reserve Index Predicts Hypoxemia during One-Lung Ventilation: An Observational Diagnostic Study. Journal of Cardiothoracic and Vascular Anesthesia, 34, 417-422. [Google Scholar] [CrossRef] [PubMed]
[2] Uhlig, C., Neto, A.S., van der Woude, M., et al. (2020) Intraopera-tive Mechanical Ventilation Practice in Thoracic Surgery Patients and Its Association with Postoperative Pulmonary Complications: Results of a Multicenter Prospective Observational Study. BMC Anesthesiology, 20, Article Number: 179. [Google Scholar] [CrossRef] [PubMed]
[3] Wei, W., Zheng, X., Zhou, C.W., et al. (2023) Protocol for the Derivation and External Validation of a 30-Day Postoperative Pulmonary Complications (PPCs) Risk Prediction Model for elderly Patients Undergoing Thoracic Surgery: A Cohort Study in Southern China. BMJ Open, 13, e066815. [Google Scholar] [CrossRef] [PubMed]
[4] Slinger, P., Suissa, S. and Triolet, W. (1992) Predicting Arteri-al Oxygenation during One-Lung Anaesthesia. Canadian Journal of Anaesthesia, 39, 1030-1035. [Google Scholar] [CrossRef] 
[5] Karzai, W. and Schwarzkopf, K. (2009) Hypoxemia during One-Lung Ventilation: Prediction, Prevention, and Treatment. Anesthesiology, 110, 1402-1411. [Google Scholar] [CrossRef] 
[6] Gao, C., Zhang, G., Sun, X., et al. (2010) The Effects of In-travenous Hyperoxygenated Solution Infusion on Systemic Oxygenation and Intrapulmonary Shunt during One-Lung Ventilation in Pigs. Journal of Surgical Research, 159, 653-659. [Google Scholar] [CrossRef] [PubMed]
[7] Schorer, R., Dombret, A.L., Hagerman, A., Bédat, B. and Putzu, A. (2023) Impact of Pharmacological Interventions on Intrapulmonary Shunt during One-Lung Ventilation in Adult Thoracic Surgery: A Systematic Review and Component Network Meta-Analysis. British Journal of Anaesthesia, 130, e92-e105. [Google Scholar] [CrossRef] [PubMed]
[8] Güldner, A., Kiss, T., Serpa Neto, A., et al. (2015) Intraoperative Protective Mechanical Ventilation for Prevention of Postoperative Pulmonary Complications: A Comprehensive Review of the Role of Tidal Volume, Positive End-Expiratory Pressure, and Lung Recruitment Maneuvers. Anesthesiology, 123, 692-713. [Google Scholar] [CrossRef] 
[9] Kidane, B., Choi, S., Fortin, D., et al. (2018) Use of Lung-Protective Strategies during One-Lung Ventilation Surgery: A Multi-Institutional Survey. Annals of Translational Medicine, 6, 269. [Google Scholar] [CrossRef] [PubMed]
[10] Kremer, R., Aboud, W., Haberfeld, O., Armali, M. and Barak, M. (2019) Differential Lung Ventilation for Increased Oxygenation during One Lung Ventilation for Video Assisted Lung Surgery. Journal of Cardiothoracic Surgery, 14, Article Number: 89. [Google Scholar] [CrossRef] [PubMed]
[11] 岳莉, 李月光, 蔡红刚, 等. 高频正压通气下喉罩在无痛纤支镜检查中的有效性与安全性研究[J]. 中外医学研究, 2014, 12(32): 22-24.
[12] 张华, 李蕾, 李伟, 等. 持续性无创正压通气和高频正压通气在老年患者胸腔镜手术中的应用[J]. 中国老年学杂志, 2016, 36(20): 5123-5125.
[13] Biro, P. and Schmid, S. (1997) Anästhesie und Hochfrequenz-Jetventilation (HFJV) für operative Eingriffe an Larynx und Trachea [Anesthesia and High Frequency Jet Ventilation (HFJV) for Surgical Interventions on the Larynx and Trachea]. HNO, 45, 43-52. [Google Scholar] [CrossRef] [PubMed]
[14] 王维, 隋波, 李冠华, 等. 高频喷射通气辅助单肺通气在胸腺瘤微创手术中的应用[J]. 军医进修学院学报, 2012, 33(4): 348-349+356.
[15] Wang, T., Pei, Y., Qiu, X., Wang, J., Wang, Y. and Zhang, J. (2022) A Multi-Centre Prospective Random Control Study of Superimposed High-Frequency Jet Ventilation and Conventional Jet Ventilation for Interven-tional Bronchoscopy. Ear, Nose & Throat Journal. [Google Scholar] [CrossRef] [PubMed]
[16] Abe, K., Oka, J., Takahashi, H., Funatsu, T., Fukuda, H. and Miyamoto, Y. (2006) Effect of High-Frequency Jet Ventilation on Oxygenation during One-Lung Ventilation in Patients Undergoing Thoracic Aneurysm Surgery. Journal of Anesthesia, 20, 1-5. [Google Scholar] [CrossRef] [PubMed]
[17] El-Tahan, M.R., Doyle, D.J. and Hassieb, A.G. (2014) High-Frequency Jet Ventilation Using the Arndt Bronchial Blocker for Refractory Hypoxemia during One-Lung Ventila-tion in a Myasthenic Patient with Asthma. Journal of Clinical Anesthesia, 26, 570-573. [Google Scholar] [CrossRef] [PubMed]
[18] Crimi, G., Conti, G., Bufi, M., et al. (1988) High Frequency Jet Ventilation (HFJV) Has No Better Haemodynamic Tolerance Than Controlled Mechanical Ventilation (CMV) in Cardi-ogenic Shock. Intensive Care Medicine, 14, 359-363. [Google Scholar] [CrossRef] 
[19] Ogawa, E., Takenaka, K., Kawashita, F., Moriyama, S. and Hirata, T. (2005) Prevention of Overlooked Bullae during Video-Assisted Thoracic Surgery (VATS) with a Combination of High Frequency Jet Ventilation (HFJV) and Positive End-Expiratory Pressure (PEEP) for Spontaneous Pneumothorax. The Thoracic and Cardiovascular Surgeon, 53, 56-60. [Google Scholar] [CrossRef] [PubMed]
[20] 周娅梅, 刘乐, 陈丽梅, 等. 高频-常频程序喷射通气时喷射导管前端位置对血二氧化碳清除效果的影响[J]. 温州医科大学学报, 2017, 47(1): 37-41.
[21] 郁雅琼. 高频振荡通气应用于单肺通气对氧合的影响[D]: [硕士学位论文]. 苏州: 苏州大学, 2014.
[22] Keith, P., Scott, L.K., Perkins, L., Burnside, R. and Day, M. (2022) High-Frequency Oscillatory Ventilation for Refractory Hypoxemia in Severe COVID-19 Pneumonia: A Small Case Series. American Journal of Case Reports, 23, e936651. [Google Scholar] [CrossRef] 
[23] Sklar, M.C., Fan, E. and Goligher, E.C. (2017) High-Frequency Os-cillatory Ventilation in Adults with ARDS: Past, Present, and Future. Chest, 152, 1306-1317. [Google Scholar] [CrossRef] [PubMed]
[24] Ayoub, D., Elmashad, A., Rowisha, M., Eltomey, M. and El Am-rousy, D. (2021) Hemodynamic Effects of High-Frequency Oscillatory Ventilation in Preterm Neonates with Respiratory Distress Syndrome. Pediatric Pulmonology, 56, 424-432. [Google Scholar] [CrossRef] [PubMed]

为你推荐