呼吸机械与干部倾斜的变化在ARDS患者与肥胖和没有肥胖之间有所不同
Shailesh Bihari1, Ubbo F Wiersema2
1Department of ICCU, Flinders Medical Centre, Bedford Park, SA, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
在患有急性呼吸窘迫综合征 (ARDS) 和肥胖症的患者中,卧卧姿势改善了呼吸机制和二氧化碳清除,与半卧姿相比. 这一发现对于优化这种患者群体的通风策略至关重要.
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:
- 干倾斜影响机械通风患者的呼吸机制ARDS.
- 仰卧平躺的姿势通常会减少肺部和胸壁的弹性.
- 干倾斜对ARDS肥胖患者呼吸机制的影响尚不清楚.
研究的目的:
- 调查姿势变化对呼吸机制的影响是否在有或没有肥胖的ARDS患者之间有所不同.
- 为了比较分区呼吸机械在不同的树干倾斜对于这些群体.
主要方法:
- 单中心研究,随机选择患有或没有肥胖的ARDS患者.
- 在15分钟的间隔内,车倾斜在半躺 (40°) 和卧卧平 (0°) 之间交替进行.
- 测量了呼吸机制,气道压力和动脉血液气体.
主要成果:
- 在肥胖的ARDS患者中,仰卧姿势降低了肺/胸壁弹性,驱动压力,并改善了CO2清除 (P < .001).
- 在肥胖患者的卧卧姿势下,气道阻力增加 (P = .006).
- 在非肥胖的ARDS患者中,仅胸壁弹性在卧卧姿势下降 (P < .001).
结论:
- 仰卧姿势可以改善肺部和胸壁的弹性,并在机械通风的ARDS患者中改善CO2清除.
- 干倾斜的姿势调整会根据ARDS患者的肥胖状况对呼吸机制产生显著影响.
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