机械通风降低了潮体积的异质性,但增加了终端呼气体积的异质性
Melissa Preissner1, Yong Song2, David Trevascus1
1Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Victoria, Australia.
Journal of applied physiology (Bethesda, Md. : 1985)
|August 17, 2023
概括
机械通风 (MV) 策略会影响肺体积的分布. 虽然保护性和损伤性MV都降低了潮体积异质性,但损伤性通风增加了终端呼气体积异质性,这表明了潜在的风险.
科学领域:
- 肺部生理学 肺部生理学
- 医学成像医学成像
- 机械通风机械通风的使用
背景情况:
- 在机械通风 (MV) 下,肺体积的异质分布尚未完全理解.
- 评估区域肺体积变化对于优化MV策略和预防肺损伤至关重要.
研究的目的:
- 评估不同MV策略对区域肺体积分布和异质性的影响.
- 为了比较有害的MV (高峰吸气压与零正极呼气压) 与保护的MV (低峰吸气压与正极呼气压).
主要方法:
- 在小鼠中利用四维计算机断层扫描 (4DCT) 高分辨率成像.
- 测量到的潮体积 (Vt) 和末尾呼气肺体积 (EEV) 音量为音量.
- 使用变化系数 (COV) 量化通风异质性.
主要成果:
- MV对全球Vt的影响最小,但在损害组中降低了EEV.
- 两种MV模式都减少了Vt异质性 (COV),但增加了EEV异质性 (COV).
- 与保护性MV相比,损害性MV显示出更高的再分配指数.
结论:
- 区域EEV变化在保护性和损害性MV策略之间存在差异.
- 这两个策略都减少了Vt异质性,但在2小时内增加了EEV异质性.
- 需要进一步的研究来将这些发现与呼吸机引起的肺损伤联系起来.
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