隔膜功能障碍预测双边肺移植后断奶的结果
Annalisa Boscolo1, Nicolò Sella2, Tommaso Pettenuzzo2
1Department of Medicine, and Thoracic Surgery and Lung Transplant Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy; Institute of Anesthesia and Intensive Care, Padua University Hospital, Padua, Italy.
Anesthesiology
|August 8, 2023
概括
隔膜功能障碍在双边肺移植接受者中很常见,并且与难以切断呼吸机相关. 隔膜加厚率和神经通风效率预测了断奶成功,与通风持续时间相反相关.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 隔膜功能障碍影响一般ICU人群的呼吸机断奶结果.
- 关于双边肺移植 (BLT) 接受者的隔膜功能和断奶的数据有限.
- 之前的研究使用了隔膜加厚分数 (DTF) 和神经呼吸器效率 (NVE).
研究的目的:
- 调查BLT接受者的隔膜功能障碍的发生率.
- 为了确定DTF和NVE是否预测BLT患者的断奶结果.
- 探索机械通风持续时间与隔膜功能障碍之间的关联.
主要方法:
- 评估了接受首次自发呼吸试验 (SBT) 的成年BLT患者.
- 隔膜加厚率 (超声波测量) 和神经呼吸器效率被记录下来.
- 根据SBT的成功,断奶结果被分为简单,困难或长时间.
主要成果:
- 隔膜功能障碍发生在32%的受试者身上,仅限于那些难以断奶的人.
- 在难以断奶的患者中观察到较低的DTF和NVE值 (P < 0.001).
- DTF和NVE都在预测难以断奶时表现出很高的准确性,与通风持续时间相反相关.
结论:
- 隔膜功能障碍在BLT后普遍存在,并与具有挑战性的断奶有关.
- 减少的DTF和NVE水平是这群人难以断奶的特征.
- DTF和NVE是断奶成功的可靠预测指标,更长的通风对这些指标产生反向影响.
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