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在接受气管插管的危重成人中，低氧血症会增加心脏骤停和死亡的风险。与氧气面罩预氧和组相比，无创预氧和组对气管插管期间低氧血症发生率的影响尚不确定。

In a multicenter, randomized trial conducted at 24 emergency departments and intensive care units in the United States, we randomly assigned critically ill adults (age, ≥18 years) undergoing tracheal intubation to receive preoxygenation with either noninvasive ventilation or an oxygen mask. The primary outcome was hypoxemia during intubation, defined by an oxygen saturation of less than 85% during the interval between induction of anesthesia and 2 minutes after tracheal Intubation.

在一项在美国24个急诊科和重症监护病房进行的多中心随机试验中，我们随机分配了接受气管插管的危重成年人(年龄≥18岁)，接受无创呼吸机或氧气面罩的预吸氧。主要结果是插管期间的低氧血症，定义为从麻醉诱导到气管插管后2分钟之间的血氧饱和度低于85%的情况。

Among the 1301 patients enrolled, hypoxemia occurred in 57 of 624 patients (9.1%) in the noninvasive-ventilation group and in 118 of 637 patients (18.5%) in the oxygen-mask group (difference, −9.4 percentage points; 95% confidence interval [CI], −13.2 to −5.6; P<0.001). Cardiac arrest occurred in 1 patient (0.2%) in the noninvasive-ventilation group and in 7 patients (1.1%) in the oxygen-mask group (difference, −0.9 percentage points; 95% CI, −1.8 to −0.1). Aspiration occurred in 6 patients (0.9%) in the noninvasive-ventilation group and in 9 patients (1.4%) in the oxygen-mask group (difference, −0.4 percentage points; 95% CI, −1.6 to 0.7).

无创通气组发生低氧血症57例(9.1%)，氧气面罩组发生低氧血症118例(18.5%)，差异有统计学意义(−9.4%；95%可信区间[CI]，−13.2到−5.6；P<0.001)。无创通气组发生心脏骤停1例(0.2%)，氧气面罩组发生心脏骤停7例(1.1%)(差异，−0.9%；95%CI，−1.8%至−0.1%)。无创通气组有6例(0.9%)发生误吸，氧气面罩组有9例(1.4%)发生误吸(差异，−0.4%；95%CI，−1.6到0.7)。

Among critically ill adults undergoing tracheal intubation, preoxygenation with noninvasive ventilation resulted in a lower incidence of hypoxemia during intubation than preoxygenation with an oxygen mask. (Funded by the U.S. Department of Defense; PREOXI ClinicalTrials.gov number, NCT05267652.)

在接受气管插管的危重成人中，插管期间预氧合使用无创通气组低氧血症的发生率低于吸氧面罩组。(由美国国防部资助；PREOXI ClinicalTrials.gov编号，NCT05267652.）