Effect of Obesity on Safe Duration of Apnea in Anesthetized Humans
Effect of Obesity on Safe Duration of Apnea in Anesthetized Humans
复制标题
肥胖对麻醉人呼吸暂停安全持续时间的影响
DOI：
10.1213/00000539-199101000-00016
复制
发表时间：
1991
影响因子：
5.7
通讯作者：
Una O'Leary
中科院分区：
文献类型：
--
作者：
H. G. Jense;S. Dubin;P. I. Silverstein;Una O'Leary
肥胖患者的功能性残气量降低，因此在呼吸暂停期间氧供应减少。为了确定肥胖患者在麻醉诱导期间是否比正常体重的患者发生低氧血症的风险更大，对24例接受择期手术的患者进行了研究。第1组（正常）在其理想体重的20%以内。第2组（肥胖）超过理想体重20%但小于45.5 kg。第3组（病态肥胖）超过理想体重45.5 kg。患者预氧5 min或直至呼出氮<5%。在麻醉诱导和肌肉放松后，允许患者保持呼吸暂停，直到通过脉搏血氧仪测量的动脉饱和度达到90%。第1组、第2组和第3组的血氧饱和度降至90%所需的时间分别为364 ± 24 s、247 ± 21 s和163 ± 15 s;这些时间在组间存在显著差异（P < 0.05）。对数据的回归分析表明，去饱和时间与肥胖增加之间存在显著的负线性相关（r =-0.83）。这些结果表明，肥胖患者在呼吸暂停时发生低氧血症的风险增加。
Obese patients have a decreased functional residual capacity and, hence, a reduced oxygen supply during periods of apnea. To determine whether obese patients are at greater risk of developing hypoxemia during induction of anesthesia than patients of normal weight, 24 patients undergoing elective surgical procedures were studied. Group 1 (normal) were within 20% of their ideal body weight. Group 2 (obese) were more than 20% but less than 45.5 kg over ideal body weight. Group 3 (morbidly obese) were more than 45.5 kg over ideal body weight. Patients were preoxygenated for 5 min or until expired nitrogen was <5%. After induction of anesthesia and muscle relaxation the patients were allowed to remain apneic until arterial saturation as measured by pulse oximetry reached 90%. The time taken for oxygen saturation to decrease to 90% was 364 ± 24 s in group 1, 247 ± 21 s in group 2, and 163 ± 15 s in group 3; these times are significantly different at P < 0.05 between groups. Regression analysis of the data demonstrated a significant negative linear correlation (r = −0.83) between time to desaturation and increasing obesity. These results show that obese patients are at an increased risk of developing hypoxemia when apneic.