干部倾斜变化对ARDS患者呼吸器效率的影响:准实验性研究
Martín H Benites1,2,3,4, David Torres2, Fabian Poblete1
1Unidad de Pacientes Críticos, Clínica Las Condes, Estoril 450, Santiago, Chile.
在急性呼吸窘迫综合征 (ARDS) 患者中,改变干倾斜的位置,从半卧卧到卧卧平躺的位置,可以改善死空间并减少二氧化碳. 这种简单的操作可以提高ARDS患者的通风分布和呼吸机制.
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
- 机械通风机械通风机械通风
背景情况:
- 干倾斜影响急性呼吸困扰综合征 (ARDS) 的呼吸机制.
- 众所周知,抬头定位可以降低驾驶压力并改善合规性.
- 对死空间和通风分布的机制和影响需要进一步阐明.
研究的目的:
- 为了评估从半卧式 (45°) 变化干倾斜到卧式 (10°) 的变化对生理死亡空间的影响.
- 评估对ARDS患者不同肺部区域的通风分布的影响.
主要方法:
- 研究了22名接受压力控制通风的ARDS患者.
- 车的倾斜度被连续改变,从45°到10°,然后再回到45°.
- 功能电阻断层扫描 (EIT) 用于评估通风分布.
主要成果:
- 仰卧平坦位置 (10°) 显著增加了潮体积和呼吸系统的符合性.
- 波尔的死空间比率下降,PaCO2水平也降低了.
- 根据EIT的数据,通风分布向背肺部区域转移有利.
结论:
- 将干倾斜变为俯卧平躺的位置可以改善生理死亡空间,并减少ARDS中的PaCO2.
- 这与增加的潮量,合规性和改进的通风分布有关.
- 车身倾斜是ARDS管理中的一个关键的,可修改的参数.
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