{"title":"WATCHMAN装置部署期间的呼吸暂停管理——附3例病例报告。","authors":"Makishi Maeda, Yusuke Yoshikawa, Shunsuke Oura, Kanako Takahashi, Sho Ohno, Naoyuki Hirata, Michiaki Yamakage","doi":"10.4103/aca.aca_11_23","DOIUrl":null,"url":null,"abstract":"<p><p>WATCHMAN is a percutaneous left atrial appendage closure device that is implanted in patients who are unsuitable for anticoagulation therapy for atrial fibrillation. During WATCHMAN implantation, inducing apnea in the patient is preferable to allow stable deployment. We present three cases in which apneic oxygenation was employed to maintain oxygenation during apnea, and oxygen reserve index (ORi<sup>TM</sup>) was measured to evaluate its safety and efficacy. Oxygen was administered continuously via the endotracheal tube during apnea. During all four apneic events in three patients (mean duration of 356 seconds), the ORi values maintained above 0.24, which is generally considered the threshold of partial pressure of arterial oxygen (PaO<sub>2</sub>) > 100 mmHg. Transcutaneous oxygen saturation and PaO<sub>2</sub> remained above 99% and 300 mmHg, respectively. There were no respiratory or circulatory complications during or after the surgery.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"458-460"},"PeriodicalIF":1.1000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691579/pdf/","citationCount":"0","resultStr":"{\"title\":\"Apnea management during WATCHMAN device deployment with apneic oxygenation: A case report of three cases.\",\"authors\":\"Makishi Maeda, Yusuke Yoshikawa, Shunsuke Oura, Kanako Takahashi, Sho Ohno, Naoyuki Hirata, Michiaki Yamakage\",\"doi\":\"10.4103/aca.aca_11_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>WATCHMAN is a percutaneous left atrial appendage closure device that is implanted in patients who are unsuitable for anticoagulation therapy for atrial fibrillation. During WATCHMAN implantation, inducing apnea in the patient is preferable to allow stable deployment. We present three cases in which apneic oxygenation was employed to maintain oxygenation during apnea, and oxygen reserve index (ORi<sup>TM</sup>) was measured to evaluate its safety and efficacy. Oxygen was administered continuously via the endotracheal tube during apnea. During all four apneic events in three patients (mean duration of 356 seconds), the ORi values maintained above 0.24, which is generally considered the threshold of partial pressure of arterial oxygen (PaO<sub>2</sub>) > 100 mmHg. Transcutaneous oxygen saturation and PaO<sub>2</sub> remained above 99% and 300 mmHg, respectively. There were no respiratory or circulatory complications during or after the surgery.</p>\",\"PeriodicalId\":7997,\"journal\":{\"name\":\"Annals of Cardiac Anaesthesia\",\"volume\":\"26 4\",\"pages\":\"458-460\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691579/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Cardiac Anaesthesia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/aca.aca_11_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Cardiac Anaesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/aca.aca_11_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Apnea management during WATCHMAN device deployment with apneic oxygenation: A case report of three cases.
WATCHMAN is a percutaneous left atrial appendage closure device that is implanted in patients who are unsuitable for anticoagulation therapy for atrial fibrillation. During WATCHMAN implantation, inducing apnea in the patient is preferable to allow stable deployment. We present three cases in which apneic oxygenation was employed to maintain oxygenation during apnea, and oxygen reserve index (ORiTM) was measured to evaluate its safety and efficacy. Oxygen was administered continuously via the endotracheal tube during apnea. During all four apneic events in three patients (mean duration of 356 seconds), the ORi values maintained above 0.24, which is generally considered the threshold of partial pressure of arterial oxygen (PaO2) > 100 mmHg. Transcutaneous oxygen saturation and PaO2 remained above 99% and 300 mmHg, respectively. There were no respiratory or circulatory complications during or after the surgery.
期刊介绍：
Annals of Cardiac Anaesthesia (ACA) is the official journal of the Indian Association of Cardiovascular Thoracic Anaesthesiologists. The journal is indexed with PubMed/MEDLINE, Excerpta Medica/EMBASE, IndMed and MedInd. The journal’s full text is online at www.annals.in. With the aim of faster and better dissemination of knowledge, we will be publishing articles ‘Ahead of Print’ immediately on acceptance. In addition, the journal would allow free access (Open Access) to its contents, which is likely to attract more readers and citations to articles published in ACA. Authors do not have to pay for submission, processing or publication of articles in ACA.
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