袋式门装置的性能和限制,用于氧化前和手动通风:一个比较的长椅和尸体研究
1Ventilation Laboratory (Vent'Lab), Medical Intensive Care Unit (ICU), Angers University Hospital, Angers, France; Med(2)Lab, Air Liquide Medical Systems, Antony, France.
袋装置 (BVD) 在心肺复苏期间的氧化和通风前的有效性各不相同. 一些BVD无法提供足够的氧气,三台显示通风不良,突出了它们的设计和功能上的差异.
科学领域:
- 紧急医疗 紧急医疗
- 呼吸系统护理 呼吸系统护理
- 医疗器械 医疗器械
背景情况:
- 袋装置 (BVDs) 在心肺复苏 (CPR) 期间对预氧化和通风至关重要.
- 最佳的氧化前期要求氧气 (FeO2) 的最小过期分数在0.85.2以上.
- 在心肺复苏过程中手动通风需要减少吸入的潮体积 (VTi),以保护肺部.
研究的目的:
- 在模拟的氧化前和通风条件下比较不同袋装置 (BVD) 的性能.
- 为了评估FeO2输送,CO2再呼吸和手动通风期间的VTi与各种BVDs.
主要方法:
- 在模拟自发呼吸 (轻度和重度条件) 的肺模型上测试了9个BVD,以测量带有和没有PEEP的FeO2,并评估CO2再呼吸.
- 在非CPR和机械CPR场景 (30:2压缩:通风) 中,由36名护理人员在人形上和3名护理人员在尸体上使用3个BVD进行手动呼吸.
主要成果:
- 三个BVD在严重条件下未能达到FeO2的目标,两个在温和条件下.
- 添加PEEP (5cmH2O) 改善了九个BVD中的八个BVD的FeO2超过0.85;一个BVD导致了CO2再呼吸.
- 对于心肺复苏,在人形和尸体模型上,三个BVD在肺保护范围以外的平均VTi (4-8mL/kgPBW) 提供了平均VTi.
结论:
- 几种BVD不一致地满足预氧化所推的FeO2.
- 使用某些BVD的手动通风保护性较低,在CPR过程中提供过多的潮体积.
- 性能差异归因于不同BVD的不同工作原理.
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