压力与体积控制的通风及其对流体响应的动态参数的影响:动物交叉研究
Amelie Zitzmann1, Tim Bandorf2, Jonas Merz2
1Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Medical Centre of Rostock, Schillingallee 35, 18057, Rostock, Germany. amelie.zitzmann@med.uni-rostock.de.
BMC anesthesiology
|September 19, 2023
概括
机械通风模式,如体积控制 (VCV) 和压力控制 (PCV) 通风,在预测流体响应时,尽管气道压力不同,但不会显著改变脉冲压力变化 (PPV) 或脉冲体积变化 (SVV).
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 血液动力学 血液动力学
背景情况:
- 脉冲压力变化 (PPV) 和脉冲体积变化 (SVV) 预测机械通风期间的流体响应.
- 传统使用涉及体积控制通风 (VCV) 与更高的潮体积 (VT).
- 目前的做法倾向于较低的静脉通风和压力控制通风 (PCV),它们具有不同的压力动态.
研究的目的:
- 研究VCV与PCV对PPV和SV的影响.
- 测试假设VCV中更高的吸入压力会导致更高的PPV.
- 在不同的流体状态下比较VCV和PCV之间的PPV和SVV.
主要方法:
- 一项自我控制的动物研究,涉及16只麻醉,通风的猪.
- 测量了呼吸道和血液动力学数据,包括PPV和SVV.
- 在VCV和PCV期间,收集了四种血管内流体状态 (IVFS) 的数据.
主要成果:
- 8只猪用完整的数据集完成了该研究.
- 潮体积和呼吸速率在VCV和PCV之间是相似的.
- 尽管峰值吸入压力 (在VCV中更高) 和驱动压力 (在PCV中更高) 的显著差异,但在任何IVFS中,PPV和SVV在模式之间没有显著差异.
结论:
- 在可比的潮体积和呼吸速率下,VCV和PCV在这种动物模型中产生类似的PPV和SVV.
- 这些发现表明,这些流体响应预测器在通风模式之间没有临床上有意义的差异.
- 需要进一步的研究来验证这些结果在人类患者.
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