Sounds Impossible, but It's Knot.
Sounds Impossible, but It's Knot.
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听起来不可能，但它是结。
DOI：
10.1097/aln.0000000000002585
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发表时间：
2019
期刊：
影响因子：
8.8
通讯作者：
Riess,MatthiasL
中科院分区：
文献类型：
--
作者：
Smith,LorenE;Heath,DillonR;Riess,MatthiasL
V AA uthor Man表示，发现气管插管周围打结。口胃管缠绕的潜在体征包括插入长度高（成人> 50-60 cm）、胃内容物引流不良、气管内插管与口胃管运动同步运动、高峰气道压力和流量-容积环与气管内插管收缩引起的固定上气道阻塞一致。口胃管和气管插管缠绕的风险因素可能包括盲目口胃管放置、多次放置尝试、插入深度的反复减小和增加以及口胃管或气管插管的手术移动。尽量减少放置尝试、插入长度、留置时间和术中操作可能会降低口胃管缠绕的发生率。使用直接喉镜或纤维支气管镜观察食管放置，或使用纵向分裂气管插管或市售插管引导器引导口胃管放置也可降低缠绕风险。2、3如果发生缠绕，使用麦吉尔镊子在直接可视化下成功解开缠绕。或者，缠绕的口胃管和气管插管可能需要作为一个整体取出，然后重新插管。
V AA uthor Man uscript it was found to be knotted around the endotracheal tube. Potential signs of orogastric tube entanglement include high inserted length (> 50–60 cm in an adult), poor drainage of gastric contents, synchronous movement of the endotracheal tube with orogastric tube movement, and high peak airway pressures and flow-volume loops consistent with fixed upper airway obstruction due to endotracheal tube constriction. Risk factors for orogastric and endotracheal tube entanglement may include blind orogastric tube placement, multiple placement attempts, repeated decreases and increases in the depth of insertion, and surgical movement of the orogastric or endotracheal tube. Minimizing placement attempts, length inserted, indwelling time, and intraoperative manipulation may decrease the incidence of orogastric tube entanglement. Visualization of esophageal placement using direct laryngoscopy or fiberoptic bronchoscopy, or guided orogastric tube placement using lengthwise split endotracheal tubes or commercially available tube guides may also reduce the risk of entanglement. 2, 3 If entanglement occurs, successful disentanglement has been documented using McGill forceps under direct visualization. Alternatively, entangled orogastric and endotracheal tubes may require removal as a unit followed by reintubation.