在非输管式胸腔镜手术中辅助胸外负压通风
Riccardo Taje1, Eleonora Fabbi2, Roberto Sorge3
1Department of Thoracic Surgery, Policlinico Tor Vergata University, V.le Oxford 81, 00133 Rome, Italy.
Journal of clinical medicine
|July 14, 2023
概括
负压通风 (NPV) 在肺部疾病的非输管胸腔镜手术期间改善了氧化. 这种方法还在特定程序中增强了肺部膨胀,为正压通风提供了安全的替代方案.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 麻醉学 麻醉学
背景情况:
- 在自发通风下的非输管胸腔镜手术中,最大限度地降低胸风险至关重要.
- 对患有严重肺气或间歇性肺病的患者进行辅助性胸前负压通风 (NPV) 的研究.
研究的目的:
- 评估NPV作为非输管胸腔镜手术中自发通风的辅助剂的疗效.
- 在氧化和肺部扩张方面,比较NPV与正压通风 (PPV).
主要方法:
- 追溯性研究涉及60名接受非输管肺体积减小手术 (LVRS) 或切割的患者.
- 通过倾向性得分匹配,NPV用于暂时的低氧化和肺部再扩张,与PPV (按需) 相比.
- 主要结局包括动脉氧张力/吸入氧的比率 (ΔPO2/FiO2),PaCO2的变化,以及术后胸部X射线扫描肺扩张得分.
主要成果:
- 在所有情况下,NPV都成功实施,而没有转换为输管.
- 在LVRS组中,与PPV相比,NPV显著改善了ΔPO2/FiO2和ΔPaCO2.
- 在形组中,NPV显示了 ΔPO2/FiO2 和肺扩张 (CXR-score) 的显著改善. 两组之间没有观察到死亡率或发病率的差异.
结论:
- 与PPV相比,在非输管胸腔镜手术 (NITS) 中辅助性胸腔外侧NPV提供了更好的氧化.
- 在切除组中,NPV也表明肺部扩张有所增强.
- NPV代表了针对特定的非输管胸部手术的可行和有效的替代方案.
相关概念视频
Mechanical Ventilation III: Noninvasive Ventilation
152
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
152
Mechanical Ventilation II: Invasive Ventilation
180
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
180
Ventilatory Modes
234
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
234
Tracheostomy Suctioning II: Procedure
342
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
342
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
711
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
711
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
21
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
21


