在麻醉下自发呼吸的患者中,压力支通风的呼吸作用:随机对照试验
Roberta Sudy1, Domitille Dereu2, Na Lin3
1Unit for Anaesthesiological Investigations, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
压力支通风可显著降低术后的肺体积损失,在患有 atelectasis 的风险的患者. 这种方法可以保持肺功能,而不会在自发呼吸过程中恶化通风不均.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 关键护理医学 关键护理医学
背景情况:
- 肺体积减少是术后呼吸道并发症的重要危险因素.
- 没有压力支的自发呼吸可能会增加脱口症的风险.
- 喉膜呼吸道通常用于在全身麻醉期间自发呼吸.
研究的目的:
- 调查压力支通风 (PSV) 是否可以防止通过喉膜口罩呼吸道自发呼吸的患者的肺功能变化.
- 为了比较连续自发呼吸 (CSB) 与PSV关于术后肺功能.
- 评估PSV对肺体积损失和通风不均性的影响.
主要方法:
- 随机对照试验涉及接受选择性妇科手术的成年女性患者.
- 患者被分配到CSB或PSV组.
- 术前和术后1小时测量肺功能,使用多次呼吸洗 (MBW) 和强制振荡.
主要成果:
- 与PSV组相比,CSB组观察到末尾呼气肺体积的明显减少 (16.6%与7.6%,p=0.0259)).
- 两组之间没有发现肺清除指数变化的显著差异.
- 小呼吸道功能和呼吸道组织硬性的术后变化在PSV组明显较低.
结论:
- 在自发呼吸的患者中,压力支通风可以防止术后的肺体积损失.
- 在这个患者群体中,PSV不会影响通风不均性.
- 这些研究结果表明,PSV对患有阿特莱克塔斯症风险增加的患者有益.
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