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Rate of decline in oxygen saturation at various pulse oximetry values with prehospital rapid sequence intubation.

机译:院前快速序列插管在各种脉搏血氧饱和度测定值下的氧饱和度下降率。

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BACKGROUND: A high incidence of desaturations has been observed during prehospital rapid sequence intubation (RSI). The rate of decline in oxygen saturation (SpO2) at various pulse oximetry values has not been defined with emergency RSI. Objective. To define the rate of SpO2 decline at various pulse oximetry values and identify a threshold below which active BVM should be performed during prehospital RSI. METHODS: Traumatic brain injury (TBI) patients undergoing RSI by prehospital providers were included in this analysis. The time period from the highest to the lowest preintubation SpO2 value was selected for review. The mean rate of SpO2 decline was calculated for each SpO2 value and then used to define a theoretical SpO2 desaturation curve. The rate of desaturation to hypoxemia (SpO2
机译:背景:院前快速序列插管(RSI)期间已观察到很高的去饱和度。紧急RSI尚未定义各种脉搏血氧饱和度值下的氧饱和度(SpO2)下降率。目的。为了定义在各种脉搏血氧饱和度值下SpO2下降的速率,并确定一个阈值,在该阈值以下,在院前RSI期间应进行主动BVM。方法:本研究纳入了院前服务提供者进行RSI的创伤性脑损伤(TBI)患者。选择从最高插管前SpO2值到最低插管SpO2值的时间范围进行检查。计算每个SpO2值的SpO2下降平均速率,然后用于定义理论SpO2脱饱和曲线。针对在每个SpO2值处启动的插管尝试定义了低氧血症的去饱和率(SpO2 <或= 90%)。结果:总共纳入了来自87例患者的684 SpO2值。较低的SpO2值与更快的SpO2下降速率相关,拐点发生在93%。 SpO2 <或= 93%引发的插管尝试导致低氧血症的去饱和率大大高于SpO2高于93%的情况(100%比6%,p <0.01)。在进行多次尝试的患者中,两次尝试之间BVM的SpO2值始终高于插管前的SpO2值。结论:SpO2下降的速率随着SpO2的减少而增加,拐点发生在93%左右。低于此值的插管尝试几乎总是与随后的去饱和有关,这表明在这些患者中,在喉镜检查之前应使用BVM。

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