控制式机械通风中机械功率的综合研究:高机械功率的普遍性和组件分析
Alejandro González-Castro1, Alberto Medina Villanueva2, Patricia Escudero-Acha1
1Department of Intensive Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Medicina intensiva
|November 23, 2023
概括
在机械通风的患者中,很大一部分可能会经历高机械功率 (MP). 虽然压力控制 (PC) 透气显示出更高的MP比体积控制 (VC) 透气,但MP升高的患病率在两种方法之间仍然相似.
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机
背景情况:
- 机械功率 (MP) 是呼吸机引起的肺损伤的一个关键因素.
- 了解临床实践中MP升高的患病率对于患者的治疗结果至关重要.
- MP监测的常规临床应用尚未标准化.
研究的目的:
- 为了确定在接受侵入性机械通风的患者中升高机械功率 (MP) 值 (>17J/分钟) 的患病率.
- 为了比较压力控制 (PC) 和体积控制 (VC) 的通风策略之间的MP值和MP升高的患病率.
主要方法:
- 进行了一项国际,多中心,观察性,横截面研究.
- 分析了接受侵入性机械通风的372名患者的数据.
- 机械功率是主要感兴趣的变量,高水平的门>17J/min.
主要成果:
- 与VC通风相比,PC通风中的平均MP显著更高 (19.20±8.44J/分钟与16.01±6.88J/分钟相比;p<0.001).
- 然而,PC和VC组之间,PM升高 (>17J/分钟) 的患者百分比没有显著差异 (41%对35%;p=0.382).
- 基于各种通风器参数,为VC和PC通风策略建立了MP的预测模型.
结论:
- 很大一部分机械通风患者可能会受到高机械功率的影响.
- 尽管平均MP值有差异,但PC和VC通风策略在高MP的患病率上并没有显著差异.
- 需要进一步的研究来优化呼吸机设置,并尽量减少肺损伤风险.
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