在机械通风过程中,单侧胸部排水对肺间压力的作用
Takayuki Hasegawa1, Yuzo Iseki2, Atsuyuki Hosono2
1Division of Anesthesia and Pain Medicine, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima City, Fukushima, Fukushima, 960-1295, Japan. fffaaahasegawa@gmail.com.
JA clinical reports
|October 27, 2023
概括
单侧胸部排水显著影响机械呼吸期间的肺透气. 它可以导致左肺和右肺之间的潮体积不平衡,这取决于所施加的负压和正极呼气压 (PEEP).
科学领域:
- 呼吸系统生理学 呼吸系统生理学
- 胸部外科手术 胸部外科手术
- 机械通风机械通风的使用
背景情况:
- 胸管排水通常使用10-20cmH2O的水下密封.
- 持续的胸部排水可以降低胸腔压力,增加肺周压力.
研究的目的:
- 为了研究单边胸部排水对潮体积和机械通风期间的驱动压力的影响.
主要方法:
- 使用了带有麻醉呼吸机的试验性肺胸模型.
- 使用控制压力或控制体积的通风来设置潮体积为300毫升.
- 独立的左和右的潮体积被测量为不同的正极呼气压 (PEEP) 和胸部排水压力.
主要成果:
- 单边胸部排水反向改变了左和右的潮体积.
- 在10cmH2O排水和0cmH2O PEEP时,左潮流体积增加.
- 在较高的排水或PEEP水平下,左潮流体积普遍下降,表明通风不平衡.
结论:
- 片面的胸部排水破坏了肺部通风平衡.
- 这种效应不论通风模式 (压力控制或体积控制) 发生.
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