隔膜外游作为潮体积的代理在侵袭性通风ICU患者的自发呼吸期间的潮体积
Matthijs L Janssen1,2, Annemijn H Jonkman1, Myrte Wennen1
1Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands.
Intensive care medicine experimental
|October 27, 2023
概括
对重症患者来说,监测潮体积至关重要. 隔膜外流的超声波测量显示了相关性,但对于定量呼吸衰竭的绝对潮体积来说不可靠.
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
- 医疗成像医学成像
背景情况:
- 精确的潮体积监测对于患有急性呼吸衰竭的重症患者至关重要.
- 在非输管患者中量化潮体积存在重大挑战.
- 隔膜外游是一种潜在的,但尚未被证明的,对潮体积的非侵入性替代品.
研究的目的:
- 为了评估超声波测量膜外流的有效性,作为呼吸衰竭患者潮体积的替代品.
- 在ICU患者和健康志愿者中评估隔膜外流和潮体积之间的相关性和一致性.
主要方法:
- 在侵入性通风ICU患者 (N=21) 和健康志愿者 (N=20) 中同时测量隔膜外流和潮体积.
- 利用线性混合模型来估计潮体积和隔膜外流之间的比率.
- 雇佣的布兰德-阿尔特曼地图来评估协议,并确定潮体积估计的变化.
主要成果:
- 在隔膜外流和潮体积之间观察到参与者内部的强烈关联 (R2=0.96在ICU患者中,R2=0.90在健康志愿者中).
- 在ICU患者 (201毫升/厘米) 和健康志愿者 (361毫升/厘米) 之间的潮体积-隔膜外流比率中发现了显著的差异.
- 显著的变异性和广泛的协议极限 (在ICU患者中±91毫升,在健康志愿者中±396毫升) 表明绝对潮体积的量化不可靠.
结论:
- 隔膜外流的超声波测量与潮体积相关.
- 在患有呼吸衰竭的患者中,使用隔膜外流测量量来量化绝对潮体积是不可靠的.
- 需要进一步的研究来探索替代的非侵入性方法来监测这个群体的潮体积.
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