"Kada ku taba shakka cewa ƙaramin rukuni na masu tunani, ƴan ƙasa masu sadaukarwa na iya canza duniya.Hasali ma, ita kaɗai a wurin.”
Manufar Cureus ita ce ta canza tsarin wallafe-wallafen likita wanda ya daɗe, wanda ƙaddamar da bincike zai iya zama tsada, rikitarwa, da cin lokaci.
Rubuta wannan labarin kamar haka: Kojima Y., Sendo R., Okayama N. et al.(Mayu 18, 2022) Matsakaicin iskar oxygen da aka shaka a cikin ƙananan na'urori masu ƙarfi da ƙarfi: nazarin kwaikwayo.Magani 14(5): e25122.doi:10.7759/cureus.25122
Manufa: Ya kamata a auna kashi na iskar oxygen da aka shayar da shi lokacin da aka ba da iskar oxygen ga mai haƙuri, tun da yake yana wakiltar ƙwayar oxygen na alveolar, wanda yake da mahimmanci daga ra'ayi na ilimin lissafi na numfashi.Don haka, manufar wannan binciken ita ce kwatanta adadin iskar oxygen da aka shaka da na'urorin isar da iskar oxygen daban-daban.
Hanyoyi: An yi amfani da samfurin kwaikwayo na numfashi ba tare da bata lokaci ba.Auna adadin iskar oxygen da aka shaka ta hanyar ƙarancin hanci da girma da kuma mashin iskar oxygen mai sauƙi.Bayan 120 s na oxygen, an auna juzu'in iskar da aka shaka kowane daƙiƙa 30.An ɗauki ma'auni uku don kowane yanayi.
SAKAMAKO: Gudun iskar ya rage intracheal wahayi zuwa ga juzu'in iskar oxygen da kuma iskar oxygen na waje yayin amfani da cannula na hanci mara ƙarfi, yana ba da shawarar cewa numfashin ƙarewa ya faru yayin sake numfashi kuma yana iya haɗuwa da haɓakar juzu'in iskar iskar oxygen.
Kammalawa.Shakar iskar oxygen yayin fitar numfashi na iya haifar da karuwar iskar oxygen a cikin matattun sararin samaniya, wanda zai iya hadewa da karuwar yawan iskar oxygen da ake shaka.Yin amfani da cannula na hanci mai girma, ana iya samun yawan adadin iskar oxygen da aka shaka ko da a cikin adadin 10 L / min.Lokacin ƙayyade mafi kyawun adadin iskar oxygen, ya zama dole don saita ƙimar da ta dace don mai haƙuri da takamaiman yanayi, ba tare da la'akari da ƙimar juzu'in iskar iskar oxygen ba.Lokacin amfani da ƙananan hancin hanci mai sauƙi da mashin iskar oxygen a cikin yanayin asibiti, yana iya zama da wahala a ƙididdige yawan iskar oxygen da aka shaka.
Gudanar da iskar oxygen a lokacin mawuyacin hali da na yau da kullun na gazawar numfashi hanya ce ta gama gari a cikin magungunan asibiti.Hanyoyi daban-daban na gudanarwar iskar oxygen sun haɗa da cannula, cannula na hanci, mashin oxygen, abin rufe fuska, venturi mask, da cannula na hanci mai girma (HFNC) [1-5].Adadin iskar oxygen a cikin iskar da aka shaka (FiO2) shine adadin iskar oxygen a cikin iskar da aka shaka wanda ke shiga musayar iskar alveolar.Matsakaicin oxygenation (rabo P/F) shine rabo na ɓangaren matsa lamba na oxygen (PaO2) zuwa FiO2 a cikin jini na jijiya.Kodayake ƙimar bincike na ƙimar P / F ya kasance mai rikitarwa, alama ce ta amfani da iskar oxygenation a cikin aikin asibiti [6-8].Saboda haka, yana da mahimmanci a asibiti don sanin ƙimar FiO2 lokacin ba da iskar oxygen ga majiyyaci.
A lokacin intubation, FiO2 za a iya auna daidai da na'urar lura da oxygen wanda ya haɗa da da'irar samun iska, yayin da lokacin da ake gudanar da iskar oxygen tare da cannula na hanci da kuma abin rufe fuska na oxygen, kawai "ƙididdigar" FiO2 dangane da lokaci mai ban sha'awa za a iya auna.Wannan "maki" shine rabon iskar oxygen zuwa ƙarar ruwa.Duk da haka, wannan baya la'akari da wasu dalilai daga ra'ayi na physiology na numfashi.Nazarin ya nuna cewa ma'aunin FiO2 na iya yin tasiri ta hanyoyi daban-daban [2,3].Kodayake gudanar da iskar oxygen a lokacin fitar da numfashi zai iya haifar da karuwa a cikin iskar oxygen a cikin matattun wurare na jiki irin su cavity, pharynx da trachea, babu rahotanni game da wannan batu a cikin wallafe-wallafen yanzu.Duk da haka, wasu likitocin sun yi imanin cewa a aikace waɗannan abubuwan ba su da mahimmanci kuma "maki" sun isa don shawo kan matsalolin asibiti.
A cikin 'yan shekarun nan, HFNC ya jawo hankali musamman a cikin maganin gaggawa da kulawa mai zurfi [9].HFNC yana ba da babban FiO2 da iskar oxygen tare da manyan fa'idodi guda biyu - zubar da mataccen sarari na pharynx da rage juriya na nasopharyngeal, wanda bai kamata a manta da shi ba lokacin rubuta iskar oxygen [10,11].Bugu da ƙari, yana iya zama dole a ɗauka cewa ƙimar FiO2 da aka auna yana wakiltar ƙwayar iskar oxygen a cikin iska ko alveoli, tun lokacin da iskar oxygen a cikin alveoli a lokacin wahayi yana da mahimmanci a cikin ma'auni na P / F.
Ana amfani da hanyoyin isar da iskar oxygen ban da intubation a cikin aikin asibiti na yau da kullun.Sabili da haka, yana da mahimmanci don tattara ƙarin bayanai akan FiO2 da aka auna tare da waɗannan na'urorin isar da iskar oxygen don hana yawan iskar oxygen da ba dole ba kuma don samun haske game da amincin numfashi yayin iskar oxygen.Koyaya, ma'aunin FiO2 a cikin trachea na ɗan adam yana da wahala.Wasu masu bincike sun yi ƙoƙari su kwaikwayi FiO2 ta amfani da samfuran numfashi na kwatsam [4,12,13].Sabili da haka, a cikin wannan binciken, mun yi nufin auna FiO2 ta amfani da samfurin simulators na numfashi ba tare da bata lokaci ba.
Wannan bincike ne na matukin jirgi wanda baya buƙatar amincewar ɗabi'a saboda bai shafi ɗan adam ba.Don yin kwatankwacin numfashi na kwatsam, mun shirya samfurin numfashi na kwatsam tare da la'akari da ƙirar da Hsu et al.(Hoto na 1) [12].Masu ba da iska da gwajin huhu (Dual Adult TTL; Grand Rapids, MI: Michigan Instruments, Inc.) daga kayan aikin sa barci (Fabius Plus; Lübeck, Jamus: Draeger, Inc.) an shirya su don kwaikwayi numfashi na kwatsam.Ana haɗa na'urorin biyu da hannu ta madaidaitan madauri na ƙarfe.Ƙaƙwalwar ƙwanƙwasa ɗaya (gefen tuƙi) na huhu gwajin yana haɗa da na'urar iska.Sauran bellows (m gefen) na gwajin huhu an haɗa su da "Oxygen Management Model".Da zaran na'urar iska ta samar da iskar gas don gwada huhu (bangaren tuƙi), ƙwanƙolin yana kumbura ta hanyar ja da sauran ɓangarorin da ƙarfi.Wannan motsi yana shakar iskar gas ta hanyar manikin trachea, don haka yana daidaita numfashin nan da nan.
(a) Oxygen Monitor, (b) Dummy, (c) Gwajin huhu, (d) Na'urar Anesthesia, (e) Kula da iskar oxygen, da (f) Na'urar hura wutar lantarki.
Saitunan mai iska sun kasance kamar haka: ƙarar tidal 500 ml, ƙimar numfashi na numfashi 10 / min, mai ban sha'awa zuwa rabo mai ƙarewa (rabin shaƙatawa / ƙarewa) 1: 2 (lokacin numfashi = 1 s).Don gwaje-gwajen, an saita yarda da huhun gwajin zuwa 0.5.
An yi amfani da mai kula da iskar oxygen (MiniOx 3000; Pittsburgh, PA: Kamfanin Sabis na Likita na Amurka) da manikin (MW13; Kyoto, Japan: Kyoto Kagaku Co., Ltd.) don tsarin sarrafa iskar oxygen.An yi allurar iskar oxygen mai tsafta a farashin 1, 2, 3, 4 da 5 L/min kuma an auna FiO2 ga kowannensu.Don HFNC (MaxVenturi; Coleraine, Ireland ta Arewa: Armstrong Medical), an gudanar da gaurayawar iskar oxygen a cikin juzu'i na 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, da 60 L, kuma FiO2 ya kasance. tantancewa a kowane hali.Don HFNC, an gudanar da gwaje-gwaje a 45%, 60% da 90% iskar oxygen.
Extraoral oxygen maida hankali (BSM-6301; Tokyo, Japan: Nihon Kohden Co.) An auna 3 cm sama da maxillary incisors tare da iskar oxygen da aka kawo ta hanci cannula (Finefit; Osaka, Japan: Japan Medicalnext Co.) (Hoto 1).) Intubation ta amfani da na'urar hura wutar lantarki (HEF-33YR; Tokyo, Japan: Hitachi) don busa iska daga kan manikin don kawar da numfashi mai ƙarewa, kuma an auna FiO2 bayan mintuna 2.
Bayan dakika 120 na bayyanar da iskar oxygen, an auna FiO2 kowane dakika 30.Sanya iska a manikin da dakin gwaje-gwaje bayan kowace aunawa.An auna FiO2 sau 3 a kowane yanayi.An fara gwajin ne bayan an daidaita kowane kayan aunawa.
A al'ada, ana tantance iskar oxygen ta hanyar cannulas na hanci don a iya auna FiO2.Hanyar lissafin da aka yi amfani da ita a cikin wannan gwaji ya bambanta dangane da abun ciki na numfashi na gaggawa (Table 1).Ana ƙididdige makin bisa la'akari da yanayin numfashi da aka saita a cikin na'urar maganin sa barci (ƙarar tidal: 500 ml, ƙimar numfashi: 10 numfashi / min, mai ban sha'awa zuwa rabo mai ƙarewa {inhalation: rabon exhalation} = 1: 2).
Ana ƙididdige "maki" don kowane adadin iskar oxygen.An yi amfani da cannula na hanci don ba da iskar oxygen zuwa LFNC.
An yi duk nazari ta amfani da software na asali (Northampton, MA: Kamfanin OriginLab).Ana bayyana sakamako azaman ma'anar ± daidaitaccen karkata (SD) na adadin gwaje-gwaje (N) [12].Mun tattara duk sakamakon zuwa wurare goma sha biyu.
Don ƙididdige "maki", adadin iskar oxygen da aka hura a cikin huhu a cikin numfashi ɗaya daidai yake da adadin iskar oxygen a cikin cannula na hanci, sauran kuma iska ne a waje.Don haka, tare da lokacin numfashi na 2 s, iskar oxygen da aka kawo ta cannula na hanci a cikin 2 s shine 1000/30 ml.Matsakaicin iskar oxygen da aka samu daga iska ta waje shine 21% na adadin tidal (1000/30 ml).FiO2 na ƙarshe shine adadin iskar oxygen da aka kawo zuwa ƙarar tidal.Sabili da haka, ana iya ƙididdige ƙimar "FiO2" ta hanyar rarraba jimlar adadin iskar oxygen da aka cinye ta ƙarar tidal.
Kafin kowane ma'auni, an daidaita ma'aunin iskar oxygen na intracheal a 20.8% kuma an daidaita ma'aunin oxygen na waje a 21%.Tebur 1 yana nuna ma'anar FiO2 LFNC a kowane ƙimar kwarara.Wadannan dabi'u sune sau 1.5-1.9 sama da ƙimar "ƙididdigar" (Table 1).Matsakaicin iskar oxygen a wajen baki ya fi na cikin iska (21%).Matsakaicin ƙimar ya ragu kafin gabatarwar kwararar iska daga fan ɗin lantarki.Waɗannan dabi'u suna kama da "ƙididdigar ƙididdiga".Tare da kwararar iska, lokacin da iskar oxygen a waje da bakin yana kusa da iska, ƙimar FiO2 a cikin trachea ya fi "ƙimar ƙididdiga" fiye da 2 L / min.Tare da ko ba tare da iska ba, bambancin FiO2 ya ragu yayin da adadin ya karu (Hoto 2).
Tebur 2 yana nuna matsakaicin ƙimar FiO2 a kowane maida hankali na oxygen don mashin oxygen mai sauƙi (Mashin oxygen Ecolite; Osaka, Japan: Japan Medicalnext Co., Ltd.).Wadannan dabi'un sun karu tare da karuwar iskar oxygen (Table 2).Tare da amfani da iskar oxygen iri ɗaya, FiO2 na LFNK ya fi na mashin oxygen mai sauƙi.A 1-5 L / min, bambanci a cikin FiO2 shine kusan 11-24%.
Teburin 3 yana nuna matsakaicin ƙimar FiO2 don HFNC a kowane ƙimar kwarara da tattara iskar oxygen.Wadannan dabi'un sun kasance kusa da manufar oxygen taro ko da kuwa ko yawan kwarara ya yi ƙasa ko babba (Table 3).
Intracheal FiO2 dabi'u sun fi 'kimantawa' dabi'u da ƙimar FiO2 na waje sun fi iska iska yayin amfani da LFNC.An gano kwararar iska don rage intracheal da extraoral FiO2.Waɗannan sakamakon suna ba da shawarar cewa numfashin ƙarewa ya faru yayin sake numfashi na LFNC.Tare da ko ba tare da kwararar iska ba, bambancin FiO2 yana raguwa yayin da yawan kwarara ya karu.Wannan sakamakon yana nuna cewa za a iya haɗa wani abu tare da haɓakar FiO2 a cikin trachea.Bugu da ƙari, sun kuma nuna cewa oxygenation yana ƙara yawan iskar oxygen a cikin matattun sararin samaniya, wanda zai iya zama saboda karuwa a FiO2 [2].An yarda gabaɗaya cewa LFNC baya haifar da sake numfashi akan numfashi.Ana sa ran cewa wannan na iya tasiri sosai ga bambanci tsakanin ma'auni da "ƙididdigar" ƙididdiga don cannulas na hanci.
A ƙananan ƙarancin 1-5 L/min, FiO2 na mashin a fili ya kasance ƙasa da na cannula na hanci, mai yiwuwa saboda ƙwayar oxygen ba ya karuwa da sauƙi lokacin da wani ɓangare na abin rufe fuska ya zama yanki mai mutuwa.Gudun iskar oxygen yana rage dilution na ɗaki kuma yana daidaita FiO2 sama da 5 L/min [12].A ƙasa 5 L/min, ƙananan ƙimar FiO2 suna faruwa saboda dilution na iska da kuma sake numfashin sararin samaniya [12].A gaskiya ma, daidaiton mita kwararar iskar oxygen na iya bambanta sosai.Ana amfani da MiniOx 3000 don saka idanu da tattarawar iskar oxygen, duk da haka na'urar ba ta da isasshen ƙuduri na ɗan lokaci don auna canje-canje a cikin iskar oxygen da aka fitar (masu sana'a sun ƙididdige daƙiƙa 20 don wakiltar amsawar 90%).Wannan yana buƙatar mai duba oxygen tare da amsawar lokaci mai sauri.
A cikin aikin asibiti na ainihi, ilimin halittar jiki na kogin hanci, kogin baki, da pharynx ya bambanta daga mutum zuwa mutum, kuma darajar FiO2 na iya bambanta da sakamakon da aka samu a cikin wannan binciken.Bugu da ƙari, yanayin numfashi na marasa lafiya ya bambanta, kuma yawan amfani da iskar oxygen yana haifar da ƙananan abun ciki na oxygen a cikin numfashi mai ƙarewa.Waɗannan sharuɗɗan na iya haifar da ƙananan ƙimar FiO2.Sabili da haka, yana da wahala a tantance abin dogaro FiO2 lokacin amfani da LFNK da mashin iskar oxygen mai sauƙi a cikin yanayin asibiti na gaske.Koyaya, wannan gwajin yana ba da shawarar cewa ra'ayoyin sararin samaniya na jiki da maimaitawar numfashi na iya yin tasiri ga FiO2.Idan aka ba da wannan binciken, FiO2 na iya ƙaruwa sosai har ma a ƙananan rates, ya danganta da yanayi maimakon "ƙididdigar ƙididdiga".
Ƙungiyar Thoracic ta Biritaniya ta ba da shawarar cewa likitocin sun ba da izinin iskar oxygen bisa ga kewayon jikewa da aka yi niyya da kuma lura da mai haƙuri don kula da kewayon jikewar manufa [14].Kodayake "ƙimar ƙididdiga" na FiO2 a cikin wannan binciken ya yi ƙasa sosai, yana yiwuwa a cimma ainihin FiO2 sama da "ƙimar ƙididdiga" dangane da yanayin mai haƙuri.
Lokacin amfani da HFNC, ƙimar FiO2 yana kusa da saiti na iskar oxygen ba tare da la'akari da yawan kwarara ba.Sakamakon wannan binciken ya nuna cewa za a iya samun manyan matakan FiO2 ko da a cikin adadin 10 L / min.Irin wannan binciken ya nuna babu canji a cikin FiO2 tsakanin 10 da 30 L [12,15].An ba da rahoton babban adadin kwararar HFNC don kawar da buƙatar yin la'akari da matattun sararin samaniya [2,16].Matattun sararin samaniya na iya yuwuwa a fitar da shi a yawan iskar oxygen sama da 10 L/min.Dysart et al.An yi hasashen cewa farkon tsarin aikin VPT na iya zama zubar da mataccen sarari na kogon nasopharyngeal, ta haka ne ya rage mataccen sararin samaniya da kuma kara yawan iskar iska na mintuna (watau iskar alveolar) [17].
Wani binciken HFNC na baya ya yi amfani da catheter don auna FiO2 a cikin nasopharynx, amma FiO2 ya kasance ƙasa da wannan gwaji [15,18-20].Ritchie et al.An ba da rahoton cewa ƙididdige ƙimar FiO2 ta kusanci 0.60 yayin da yawan iskar gas ya ƙaru sama da 30 L/min yayin numfashin hanci [15].A aikace, HFNCs suna buƙatar ƙimar kwarara na 10-30 L/min ko sama da haka.Saboda kaddarorin HFNC, yanayi a cikin kogon hanci yana da tasiri mai mahimmanci, kuma HFNC galibi ana kunna shi a babban adadin kwarara.Idan numfashi ya inganta, ana iya buƙatar raguwar adadin kwarara, saboda FiO2 na iya isa.
Waɗannan sakamakon sun dogara ne akan simulations kuma ba su ba da shawarar cewa za a iya amfani da sakamakon FiO2 kai tsaye ga marasa lafiya na gaske ba.Koyaya, dangane da waɗannan sakamakon, a cikin yanayin intubation ko na'urori ban da HFNC, ana iya tsammanin ƙimar FiO2 za ta bambanta sosai dangane da yanayin.Lokacin ba da iskar oxygen tare da LFNC ko mashin iskar oxygen mai sauƙi a cikin saitin asibiti, yawanci ana tantance jiyya ne kawai ta ƙimar "jinjin iskar oxygen jikewa" (SpO2) ta amfani da oximeter pulse.Tare da ci gaban anemia, ana ba da shawarar kula da mai haƙuri sosai, ba tare da la'akari da SpO2, PaO2 da abun ciki na oxygen a cikin jini na jini ba.Bugu da kari, Downes et al.da Beasley et al.An ba da shawarar cewa marasa lafiya marasa ƙarfi na iya kasancewa cikin haɗari saboda yin amfani da prophylactic na maganin iskar oxygen sosai [21-24].A lokacin lokutan lalacewa ta jiki, marasa lafiya da ke karɓar iskar oxygen mai mahimmanci za su sami babban karatun oximeter na bugun jini, wanda zai iya rufe raguwa a hankali a cikin rabon P / F kuma don haka bazai faɗakar da ma'aikatan a daidai lokacin ba, wanda ke haifar da lalacewa mai zuwa da ke buƙatar sa hannun injiniya.goyon baya.A baya an yi tunanin cewa babban FiO2 yana ba da kariya da aminci ga marasa lafiya, amma wannan ka'idar ba ta dace da yanayin asibiti ba [14].
Sabili da haka, ya kamata a kula ko da lokacin da ake rubuta iskar oxygen a cikin lokacin aiki ko kuma a farkon matakan gazawar numfashi.Sakamakon binciken ya nuna cewa ana iya samun ma'aunin FiO2 daidai tare da intubation ko HFNC.Lokacin amfani da LFNC ko abin rufe fuska mai sauƙi na oxygen, yakamata a samar da iskar oxygen mai kariya don hana ƙarancin numfashi.Waɗannan na'urorin ƙila ba za su dace ba lokacin da ake buƙatar ƙima mai mahimmanci na matsayin numfashi, musamman lokacin da sakamakon FiO2 ke da mahimmanci.Ko da a ƙananan rates, FiO2 yana ƙaruwa tare da iskar oxygen kuma yana iya rufe gazawar numfashi.Bugu da ƙari, ko da lokacin amfani da SpO2 don magani na baya, yana da kyawawa don samun ƙarancin ƙarancin gudu kamar yadda zai yiwu.Wannan ya zama dole don gano farkon gazawar numfashi.Yawan iskar oxygen yana ƙara haɗarin gazawar ganowa da wuri.Ya kamata a ƙayyade adadin iskar oxygen bayan ƙayyade waɗanne alamomi masu mahimmanci da aka inganta tare da kulawar oxygen.Dangane da sakamakon wannan binciken kadai, ba a ba da shawarar canza yanayin kula da iskar oxygen ba.Duk da haka, mun yi imanin cewa sababbin ra'ayoyin da aka gabatar a cikin wannan binciken ya kamata a yi la'akari da hanyoyin da ake amfani da su a cikin aikin asibiti.Bugu da ƙari, lokacin ƙayyade adadin iskar oxygen da aka ba da shawarar ta hanyar jagororin, ya zama dole don saita kwararar da ya dace ga mai haƙuri, ba tare da la'akari da ƙimar FiO2 don ma'auni na yau da kullum ba.
Muna ba da shawarar sake yin la'akari da manufar FiO2, la'akari da iyakokin maganin iskar oxygen da yanayin asibiti, tun da FiO2 siga ce mai mahimmanci don sarrafa iskar oxygen.Koyaya, wannan binciken yana da iyakancewa da yawa.Idan za a iya auna FiO2 a cikin trachea na mutum, za a iya samun madaidaicin ƙimar.Koyaya, a halin yanzu yana da wahala a yi irin waɗannan ma'auni ba tare da ɓarna ba.Ya kamata a gudanar da ƙarin bincike ta amfani da na'urori masu aunawa marasa lalacewa a nan gaba.
A cikin wannan binciken, mun auna intracheal FiO2 ta amfani da samfurin simintin numfashi na LFNC, mashin oxygen mai sauƙi, da HFNC.Gudanar da iskar oxygen a lokacin fitar da numfashi zai iya haifar da karuwa a cikin iskar oxygen a cikin matattun sararin samaniya, wanda zai iya haɗuwa da karuwa a cikin adadin iskar oxygen da aka shaka.Tare da HFNC, ana iya samun babban rabo na iskar oxygen da aka shaka ko da a saurin gudu na 10 l/min.Lokacin da kayyade mafi kyau duka adadin oxygen, shi wajibi ne don kafa dace kwarara kudi ga mãsu haƙuri da takamaiman yanayi, ba dogara kawai a kan dabi'u na juzu'i na iskar oxygen.Ƙididdiga yawan iskar oxygen da ake shaka lokacin amfani da LFNC da mashin iskar oxygen mai sauƙi a cikin yanayin asibiti na iya zama ƙalubale.
Bayanan da aka samu sun nuna cewa numfashi na karewa yana hade da karuwa a cikin FiO2 a cikin trachea na LFNC.Lokacin da aka ƙayyade adadin iskar oxygen da aka ba da shawarar ta hanyar jagororin, ya zama dole don saita yanayin da ya dace ga mai haƙuri, ba tare da la'akari da ƙimar FiO2 da aka auna ta amfani da kwararar al'ada na al'ada ba.
Batutuwan Dan Adam: Dukkan marubuta sun tabbatar da cewa babu wani mutum ko kyallen takarda da ke da hannu a wannan binciken.Abubuwan Dabbobi: Duk marubuta sun tabbatar da cewa babu dabbobi ko kyallen takarda da ke da hannu a cikin wannan binciken.Rikice-rikice na Sha'awa: Dangane da Form Bayyanar ICMJE Uniform, duk mawallafa suna bayyana abubuwan da ke gaba: Bayanan Biyan Kuɗi / Sabis: Duk marubutan sun bayyana cewa ba su sami tallafin kuɗi daga kowace ƙungiya don aikin da aka ƙaddamar ba.Dangantakar Kuɗi: Duk marubutan sun bayyana cewa ba su da alaƙar kuɗi a halin yanzu ko a cikin shekaru uku da suka gabata tare da kowace ƙungiyar da ke da sha'awar aikin da aka ƙaddamar.Sauran Dangantaka: Duk mawallafa sun bayyana cewa babu wasu alaƙa ko ayyukan da zasu iya shafar aikin da aka ƙaddamar.
Muna so mu gode wa Mista Toru Shida (IMI Co., Ltd, Kumamoto Customer Service Center, Japan) don taimakonsa da wannan binciken.
Kojima Y., Sendo R., Okayama N. et al.(Mayu 18, 2022) Matsakaicin iskar oxygen da aka shaka a cikin ƙananan na'urori masu ƙarfi da ƙarfi: nazarin kwaikwayo.Magani 14(5): e25122.doi:10.7759/cureus.25122
© Haƙƙin mallaka 2022 Kojima et al.Wannan labarin buɗe ido ne wanda aka rarraba ƙarƙashin sharuɗɗan lasisin Haɗin Haɗin Halittun Halittu CC-BY 4.0.An ba da izinin amfani mara iyaka, rarrabawa, da haɓakawa a kowace matsakaici, in dai an ƙididdige ainihin marubucin da tushen.
Wannan labarin buɗaɗɗen shiga ne wanda aka rarraba ƙarƙashin Lasisin Haɗin Haɗin Halittun Halittu, wanda ke ba da izinin amfani mara iyaka, rarrabawa, da haɓakawa a kowace matsakaici, in dai an ƙididdige marubucin da tushen.
(a) Oxygen Monitor, (b) Dummy, (c) Gwajin huhu, (d) Na'urar Anesthesia, (e) Kula da iskar oxygen, da (f) Na'urar hura wutar lantarki.
Saitunan mai iska sun kasance kamar haka: ƙarar tidal 500 ml, ƙimar numfashi na numfashi 10 / min, mai ban sha'awa zuwa rabo mai ƙarewa (rabin shaƙatawa / ƙarewa) 1: 2 (lokacin numfashi = 1 s).Don gwaje-gwajen, an saita yarda da huhun gwajin zuwa 0.5.
Ana ƙididdige "maki" don kowane adadin iskar oxygen.An yi amfani da cannula na hanci don ba da iskar oxygen zuwa LFNC.
Quotient Impact Quotient ™ (SIQ™) shine na musamman namu na musamman na bitar bitar takwarorinmu.Nemo ƙarin anan.
Wannan hanyar haɗin za ta kai ku zuwa gidan yanar gizo na ɓangare na uku wanda ba shi da alaƙa da Cureus, Inc. Lura cewa Cureus ba shi da alhakin duk wani abun ciki ko ayyukan da ke ƙunshe akan abokan hulɗarmu ko rukunin yanar gizo masu alaƙa.
Quotient Impact Quotient ™ (SIQ™) shine na musamman namu na musamman na bitar bitar takwarorinmu.SIQ™ yana kimanta mahimmanci da ingancin labarai ta amfani da hikimar gamayya na al'ummar Cureus.Ana ƙarfafa duk masu amfani da rajista don ba da gudummawa ga SIQ™ na kowane labarin da aka buga.(Marubuta ba za su iya tantance labaran nasu ba.)
Ya kamata a keɓance manyan ƙididdiga don ingantaccen aiki na gaske a fannonin su.Duk wani ƙima sama da 5 yakamata a yi la'akari da shi sama da matsakaici.Duk da yake duk masu amfani da Cureus masu rijista na iya ƙididdige kowane labarin da aka buga, ra'ayoyin ƙwararrun batutuwa suna ɗaukar nauyi fiye da na waɗanda ba ƙwararru ba.SIQ™ na labarin zai bayyana kusa da labarin bayan an ƙididdige shi sau biyu, kuma za a sake ƙididdige shi tare da kowane ƙarin maki.
Quotient Impact Quotient ™ (SIQ™) shine na musamman namu na musamman na bitar bitar takwarorinmu.SIQ™ yana kimanta mahimmanci da ingancin labarai ta amfani da hikimar gamayya na al'ummar Cureus.Ana ƙarfafa duk masu amfani da rajista don ba da gudummawa ga SIQ™ na kowane labarin da aka buga.(Marubuta ba za su iya tantance labaran nasu ba.)
Da fatan za a lura cewa ta yin haka kun yarda a ƙara zuwa jerin wasiƙar imel ɗin mu na wata-wata.