神经刺激以预防腹膜功能障碍和呼吸机引起的肺损伤
Alessandro Panelli1, Michael A Verfuß1, Martin Dres2,3
1Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
Intensive care medicine experimental
|December 18, 2023
概括
神经刺激 (PNS) 有助于在机械通风患者中诊断和潜在地治疗隔膜功能障碍. 这项技术有望改善患者的治疗结果并减少通风持续时间.
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
- 神经肌肉康复疗法 神经肌肉康复疗法
背景情况:
- 机械通风可以导致呼吸机诱导的隔膜功能障碍 (VIDD) 和呼吸机诱导的肺损伤 (VILI).
- 神经刺激 (PNS) 是通过评估呼吸肌肉强度来诊断VIDD的关键.
- 减少呼吸肌肉强度与延长通风和增加死亡率相关.
研究的目的:
- 探索神经刺激 (PNS) 在重症监护中的诊断和治疗应用.
- 评估PNS在管理呼吸机诱导的隔膜功能障碍 (VIDD) 和隔膜缩方面的潜力.
- 评估各种PNS呼吸辅助方法的安全性和有效性.
主要方法:
- 使用非侵入性的电磁PNS来测量隔膜压力,用于隔膜强度评估.
- 调查各种PNS应用形式,包括侵入性/非侵入性和电磁刺激.
- 分析隔膜活动指标,如外出,加厚分数和PNS后的厚度.
主要成果:
- 非侵入性的电磁PNS作为隔膜强度和功能的参考.
- 治疗性PNS已在健康和重症患者中显示出可行性和安全性.
- PNS显示了增加启发性肌肉强度和改善隔膜活动的潜力.
结论:
- PNS是一种有前途的治疗干预措施,用于改善VIDD,并在肺部保护范围内实现隔膜训练.
- PNS可能间接降低呼吸器诱导肺损伤 (VILI) 的风险.
- 需要进一步的研究来探索PNS在重症监护中的长期结果和先进应用.
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