通过食道压力监测了解心肺相互作用
Elena Spinelli1, Gaetano Scaramuzzo2, Douglas Slobod3
1Department of Anesthesia, Critical Care and Emergency, IRCCS (Institute for Treatment and Research) Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy.
Frontiers in physiology
|August 4, 2023
概括
消化管压力监测估计了膜压力变化,提供了通风过程中对心脏功能的见解. 这种方法有助于理解和个性化治疗危急病患者.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 呼吸机械学 呼吸机械
背景情况:
- 消化管压力 (Pes) 接近于肺部压力 (Ppl) 的估计.
- 胸内压力变化,反映在Pes,显著影响心血管性能.
- 了解这些影响对于管理重症患者至关重要.
研究的目的:
- 阐明食道压力与心血管动态之间的关系.
- 探索食道压力在不同呼吸模式期间对右室和左室功能的影响.
- 突出食道压力监测在重症监护中的临床实用性.
主要方法:
- 利用食道压力监测作为腹压力的替代品.
- 分析了食道压力变化对静脉回流,心室余负荷和氧气消耗的影响.
- 在危急病患者的被动和自发呼吸期间比较效果.
主要成果:
- 在被动呼吸期间增加食道压力减少了静脉回流和增加了右心室后负荷.
- 自发呼吸的负膜压力波动增加了静脉回归,但也增加了右心脏的负载.
- 在自发呼吸过程中,左心室末端透气压升高,可能导致肺.
结论:
- 消化管压力监测提供了一种实用的床边方法来评估腹腔压力.
- 这项技术增强了对呼吸急症患者心血管性能的理解.
- 它可以指导个性化,基于生理学的治疗策略.
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