在接受长期侵入性通风治疗的重症监护患者中,压力支通风
Wisam Al-Bassam1, Tapan Parikh1, Ary Serpa Neto2,3,4
1Department of Intensive Care, Monash Medical Centre, Melbourne, VIC, Australia.
概括
压力支通风 (PSV) 在长时间的机械通风中很常见,但通常涉及高潮量和过度辅助. 管理策略需要改进,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 机械通风机械通风机械通风
背景情况:
- 长期的侵入性机械通风 (≥7天) 在重症患者中很常见.
- 在这个人群中,压力支通风 (PSV) 的使用和管理以前没有被描述.
研究的目的:
- 分析在接受长期机械通风治疗的重症患者中PSV的利用和管理模式.
主要方法:
- 在澳大利亚进行了一项多中心的回顾性观察研究.
- 呼吸器管理的数据,包括PSV设置和患者反应,在呼吸的前7天内每天收集两次.
主要成果:
- 到第7天,PSV在63.4%的患者中使用,占通风时间的40.5%.
- 在PSV期间的平均潮体积高于强制通风期间 (8.3比7.5毫升/公斤PBW).
- 过度辅助 (基于快速浅呼吸指数) 观察到79.5%的PSV治疗患者和52.4%的PSV时刻,通常没有调整.
结论:
- 在长时间的机械通风中经常使用PSV,但通常与高潮量和过度辅助有关.
- 当前的PSV管理可能不符合最佳设置,可能导致不良结果.
- 研究结果强调需要进行干预研究,以优化长时间通风设置中的PSV管理.
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