通过两种不同的自发呼吸试验,比较肺气化和呼吸力度:T片与压力支通风
Raquel Bosch-Compte1, Francisco José Parrilla1, Rosana Muñoz-Bermúdez1
1Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
Medicina intensiva
|October 5, 2023
概括
两种自发呼吸试验方法,T片和压力支通风,在通风患者中对肺空气和呼吸力度产生了类似的影响. 这两种策略都导致机械通风在断奶期间的空气损失和呼吸力度相似.
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
- 肺动脉工程 肺动脉工程
背景情况:
- 自发呼吸试验 (SBT) 对于将患者从机械通风中断至关重要.
- 在SBT过程中评估肺空气和呼吸力度对于成功的输出管至关重要.
- 不同的SBT方法,如T-piece (T-T) 和压力支通风 (PSV),可能会以不同的方式影响呼吸机制.
研究的目的:
- 为了比较T片与PSV支持的SBT对肺空气和呼吸力的影响.
- 用电阻断层扫描 (EIT) 和肺超声波 (LUS) 来评估肺气化变化.
- 通过隔膜超声波 (DU) 来评估呼吸力度.
主要方法:
- 一项前性随机研究,涉及43名机械呼吸患者.
- 患者接受了30分钟的SBT,使用标准化设置的T片 (n=20) 或PSV (n=23).
- 肺气化 (EIT,LUS) 和呼吸力度 (DU) 在基线,SBT结束和输出管后一小时被测量.
主要成果:
- 在T-T和PSV组之间没有观察到肺气化损失的显著差异 (p > 0.05).
- 隔膜外流倾向于随着空气流失而减少,在输出管之后的时期.
- 肺部超声波 (LUS) 显示,与EIT相比,通风变化的百分比更高 (68.1%与4.9%,p ≤0.001).
结论:
- 无论是T片式通风还是压力支通风都是可比的SBT策略,涉及到肺空气和呼吸力.
- 两种方法都没有在防止空气损失或减少断奶过程中的呼吸力度方面显示出显著的优势.
- 这些发现表明,患者特定的因素可能比使用的特定SBT方法更有影响力.
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