A Remote-Controlled Airbag Device Can Improve Upper Airway Collapsibility by Producing Head Elevation With Jaw Closure in Normal Subjects Under Propofol Anesthesia.
A Remote-Controlled Airbag Device Can Improve Upper Airway Collapsibility by Producing Head Elevation With Jaw Closure in Normal Subjects Under Propofol Anesthesia.
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DOI：
10.1109/jtehm.2014.2321062
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发表时间：
2014
影响因子：
3.4
通讯作者：
Ayuse T
中科院分区：
文献类型：
--
作者：
Ishizaka S;Moromugi S;Kobayashi M;Kajihara H;Koga K;Sugahara H;Ishimatsu T;Kurata S;Kirkness JP;Oi K;Ayuse T
单纯通过手动操作来持续维持下颌骨和头部的适当位置是困难的，尽管这种手法可以在睡眠和麻醉期间恢复呼吸道通畅。本研究的目的是观察在异丙酚麻醉过程中，使用远程控制的气囊装置(如气囊系统)进行头部抬高和闭合颌骨对被动上呼吸道塌陷性的影响。研究对象为7名男性受试者。麻醉诱导和维持采用丙泊酚靶控输注，目标血药浓度为1.5~2g/ml，间歇降低鼻罩压力()以评估上呼吸道塌陷性(被动)和上游阻力()，分别在仰卧位、仰卧位、嗅探位、6 cm高度嗅探位和6 cm高度嗅探位观察上呼吸道塌陷性和上游阻力。6厘米高的闭合下巴的嗅探姿势是通过安装在受试者头状头盔上的安全气囊装置实现的。采用单因素方差分析和后处理Tukey检验对患者的人口学特征进行比较。被认为意义重大。我们还在一项临床研究中证实了我们的安全气囊装置对改善三名阻塞性睡眠呼吸暂停患者上呼吸道塌陷性的效果。与基线位置(-cm Ho)相比，使用充气机器人安全气囊系统的6 cm头部抬高和下颌闭合相结合降低了上呼吸道的塌陷性(-cm Ho)。在临床研究中，睡眠呼吸暂停患者的上呼吸道阻塞有改善，包括呼吸暂停和低呼吸持续时间缩短，最低血氧饱和度升高。我们证明，在异丙酚麻醉和睡眠期间，通过使用充气气囊系统的远程控制气囊装置实现头部抬高和颌骨关闭，可以显著降低上呼吸道的塌陷性，并保持上呼吸道通畅。对于正在接受手术或影像研究的镇静剂患者，以及睡眠呼吸暂停患者，上呼吸道塌陷是一个危险的问题。本文介绍了两项临床试验的结果，这些试验检验了远程控制安全气囊装置在手术或诊断性成像中控制头部、颈部和颌部位置、防止呼吸道塌陷以及预防睡眠呼吸暂停的效果。这两项研究的结果都证明了该设备的前景。
Continuous maintenance of an appropriate position of the mandible and head purely by manual manipulation is difficult, although the maneuver can restore airway patency during sleep and anesthesia. The aim of this paper was to examine the effect of head elevation with jaw closure using a remote-controlled airbag device, such as the airbag system, on passive upper airway collapsibility during propofol anesthesia. Seven male subjects were studied. Propofol infusion was used for anesthesia induction and maintenance, with a target blood propofol concentration of 1.5–2 g/ml. Nasal mask pressure () was intermittently reduced to evaluate upper airway collapsibility (passive ) and upstream resistance () at three different head and jaw positions, jaw opening position in the supine position, jaw opening position in the sniffing position with 6-cm head elevation, and jaw closure at a 6-cm height sniffing position. The 6-cm height sniffing position with jaw closure was achieved by an airbag device that was attached to the subject’s head-like headgear. Patient demographics, and in each condition were compared using one-way ANOVA with a post hoc Tukey test. was considered significant. We also confirmed the effects of our airbag device on improvement of upper airway collapsibility in three obstructive sleep apnea patients in a clinical study. The combination of 6-cm head elevation with jaw closure using the air-inflatable robotic airbag system decreased upper airway collapsibility (-cm HO) compared with the baseline position (-cm HO, ). In the clinical study, there was improvement of upper airway obstruction in sleep apnea patients, including decreased apnea and hypopnea duration and increased the lowest level of oxygen saturation. We demonstrated that establishment of head elevation with jaw closure achieved by a remote-controlled airbag device using an inflatable airbag system can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia and sleep. Upper airway collapse is a dangerous problem in sedated patients who are undergoing surgery or imaging studies, and in people with sleep apnea. This paper presents the result of two clinical trials that examined the effect of a remote-controlled airbag device to control head, neck and jaw position and prevent airway collapse in patients who are sedated for surgery or diagnostic imaging, and for prevention of sleep apnea. The results of both studies demonstrate the promise of the device.