在电阻断层扫描中使用不同的指标进行区域性肺 perfusion
Timothy G Gaulton1, Kevin Martin1, Yi Xin1
1Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Journal of applied physiology (Bethesda, Md. : 1985)
|July 13, 2023
概括
碳酸可能是一个可行的替代高压盐水,以电阻断断层扫描测量肺 perfusion. 这一发现可以改善急性呼吸困扰综合征 (ARDS) 患者的床边监测.
科学领域:
- 关键护理医学 关键护理医学
- 肺部生理学 肺部生理学
- 医学成像技术 医学成像技术
背景情况:
- 急性呼吸困扰综合征 (ARDS) 管理侧重于肺部保护和机械通风,但肺 perfusion 干扰至关重要.
- 缺乏精确的肺 perfusion 的床边监测,阻碍了 ARDS 的诊断和治疗.
- 电阻断层扫描 (EIT) 可以使用导电指标估计区域性肺 perfusion,但标准指标 (高压化) 的可访问性有限.
研究的目的:
- 调查二碳酸作为使用EIT进行区域性肺 perfusion测量指标的可比性,与标准的高压化相比.
- 在猪肺损伤模型中评估二碳酸和高度化之间的协议,用于EIT衍生的肺 perfusion.
主要方法:
- 在5头猪身上使用了猪肺损伤模型.
- 使用EIT测量区域肺 perfusion,使用12%的化和8.4%的碳酸作为指标.
- 对不同肺部区域和实验条件 (身体位置,PEEP) 的输液进行了分析.
- 基于指标的阻抗信号的最大斜率分析被用来确定区域性 perfusion.
主要成果:
- 使用碳酸的区域肺 perfusion 的估计显示强烈一致性与高性化总体 (平均偏差为 0%) 和肺象限内.
- 这两个指标之间的一致性在各种实验条件下保持一致.
- 在不同条件下观察到区域肺 perfusion 估计差异没有显著变化.
结论:
- 碳酸在通过EIT估计区域性肺输液时,表现与高度化相当.
- 碳酸在ARDS中为床边EIT基础的肺 perfusion 监测提供了一个潜在的更容易获得和实用的指标.
- 这一发现支持在临床环境中更广泛地采用EIT进行实时肺 perfusion 评估.
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