胃肠内窥镜术中适度镇静期间低氧血症:原因和关联。

PubMed ID
发表日期 2011年月

原始出处 消化
Digestion
作者 Qadeer  Mohammed A  Lopez  A Rocio  Dumot  John A  Vargo  John J 

文献标题 胃肠内窥镜术中适度镇静期间低氧血症:原因和关联。
Hypoxemia during moderate sedation for gastrointestinal endoscopy: causes and associations.

文献摘要 BACKGROUND/AIMS

虽然长期低氧血症(以下称为低氧血症)在内窥镜检查的中度镇静期间并不少见,但关于其与药物、内窥镜检查插管和通气模式的关系的数据很少。我们旨在研究这些关系。

METHODS

在一项随机试验的对照组中,对123名患者进行了内窥镜检查期间的通气监测分析。低氧血症被定义为氧饱和度<90%≥15秒,呼吸暂停,因为≥15秒。

RESULTS

有132例低氧事件;46(35%)和112(85%)事件发生在给药/内窥镜插管的1分钟和5分钟内,相反,所有给药/内窥镜插管的46/638(7%)和112/638(18%)分别在1分钟和5分钟内导致低氧血症。呼吸暂停、通气异常和通气正常分别与36%、30%和34%的低氧血症事件相关。然而,只有101/268(38%)例呼吸暂停/异常通气事件导致低氧血症。呼吸暂停的显著预测因子为哌替啶/芬太尼总剂量1.3(1.02-1.6)和咪达唑仑总剂量0.84(0.71-0.99)。

CONCLUSIONS

低氧血症通常发生在给药或内窥镜插管后5分钟内,只有三分之一的呼吸暂停/异常通气事件最终导致低氧血症。


BACKGROUND/AIMS

Although prolonged hypoxemia (henceforth referred to as hypoxemia) is not uncommon during moderate sedation for endoscopy, there are only sparse data regarding its relationship with medications, endoscopic intubations and ventilation patterns. We aimed to study these relationships.

METHODS

123 patients enrolled in the control arm of a randomized trial of ventilation monitoring during endoscopy were analyzed. Hypoxemia was defined as oxygen saturation of <90% for ≥15 s, and apnea as lack of respiratory activity for ≥15 s.

RESULTS

There were 132 hypoxemic events; 46 (35%) and 112 (85%) events occurred within 1 and 5 min of medication administration/endoscopic intubations, and conversely, 46/638 (7%) and 112/638 (18%) of all medication administration/endoscopic intubations led to hypoxemia in 1 and 5 min, respectively. Apnea, abnormal ventilation and normal ventilation were associated with 36, 30 and 34% of all hypoxemia events, respectively. However, only 101/268 (38%) apnea/abnormal ventilation events led to hypoxemia. Significant predictors of apnea were total dose of meperidine/fentanyl 1.3 (1.02-1.6) and total dose of midazolam 0.84 (0.71-0.99).

CONCLUSIONS

Hypoxemia occurs typically within 5 min of medication administration or endoscope intubation and only one third of all apnea/abnormal ventilation events eventually lead to hypoxemia.


获取全文 10.1159/000321621