全肺洗减少了肺膜蛋白质症患者的生理死空间:两个病例报告
Tatsuya Fujihara1, Atsuko Shono2, Nozomi Katayama3
1Division of Emergency and Critical Care Department, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, Shimane, 693-8555, Japan. tatsuyahujihara898@gmail.com.
Journal of medical case reports
|August 18, 2023
概括
全肺洗 (WLL) 通过去除表面活性剂,改善肺膜膜蛋白质症 (PAP) 中的气膜通风. 然而,洗液的吸收可以暂时增加肺水和死空间.
科学领域:
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
- 身体生理学 身体生理学
背景情况:
- 肺膜蛋白质症 (PAP) 是一种罕见的肺部疾病,具有表面活性剂的积累.
- 全肺洗 (WLL) 是标准的治疗方法,但没有术后监测.
- 间接热量计可以测量二氧化碳的产生和死空间.
研究的目的:
- 为了评估WLL在PAP患者的生理影响.
- 评估WLL对二氧化碳排放和肺部水的影响.
- 探索间接热量计作为WLL的床边监测工具.
主要方法:
- 使用间接热量计测量每次呼吸的二氧化碳排放量 (VTCO2,br) 和恩霍夫的死空间.
- 在WLL之前和之后评估了血管外肺水和心脏指数.
- 分析了两名PAP患者四次WLL手术的数据.
主要成果:
- VTCO2,br增加,而Enghoff的死空间在WLL.12小时后减少.
- 血管外肺水在WLL后立即增加.
- 由于肺部吸收水的原因,Enghoff的死空间的暂时增加被观察到.
结论:
- 通过清除表面活性剂,WLL增强了气膜通风.
- 在WLL后的洗液吸收可以暂时增加肺水和死空间.
- 间接热量计显示了监测WLL生理影响的潜力.
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