脊髓输液压与急性部创伤脊髓损伤患者的呼吸功能相关:一项观察性研究
Ravindran Visagan1, Ellaine Boseta1,2, Argyro Zoumprouli2
1Academic Neurosurgery Unit, St. George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
Critical care (London, England)
|September 20, 2023
概括
在宫创伤性脊髓损伤后,维持脊髓 perfusion 压力 (SCPP) 在 80-90 mmHg 之间对于最佳的呼吸功能至关重要. 这一发现可能有助于通过促进呼吸机释放来减少神经重症监护室的停留时间.
科学领域:
- 神经学 神经学
- 肺部病理学 肺部病理学
- 临界护理医学 临界护理医学
背景情况:
- 部创伤性脊髓损伤 (TSCI) 显著损害呼吸功能.
- 脊髓输液压 (SCPP) 是SCI管理中的关键生理参数.
- 在急性TSCI中,SCPP与呼吸功能之间的关系还不清楚.
研究的目的:
- 调查脊髓输液压 (SCPP) 与急性部创伤性脊髓损伤患者的呼吸肌功能之间的关联.
- 确定一个最佳的SCPP范围,以保持呼吸能力.
主要方法:
- 包括13名宫性TSCI患者 (亚洲A-C等级) 和8名对照.
- 监测脊柱内压力和计算SCPP (平均动脉压 - 脊柱内压力).
- 使用隔膜电肌图 (EDI) 和呼吸肌的超声波评估呼吸功能.
主要成果:
- 较低的SCPP (<60 mmHg) 与减少的隔膜电活动 (EDI) 有关.
- 隔膜和肋间肌肉功能显示了与SCPP的反转-U关系,高峰在80-90mmHg.
- 腹部呼吸发生在SCPP<80或>100 mmHg时,表明肋间肌肉功能受损.
结论:
- 在急性宫性TSCI后的呼吸功能取决于SCPP.
- 80-90mmHg的SCPP范围优化了腹膜和肋间肌肉功能.
- 在这个范围内保持SCPP可能会加速呼吸器释放,并减少神经-ICU停留时间.
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