低血量患者恢复自发呼吸的Pendelluft:比例模式与压力支通风相比
Daniel H Arellano1,2, Roberto Brito1, Caio C A Morais3,4
1Departamento de Medicina, Unidad de Pacientes Críticos, Hospital Clínico Universidad de Chile, Dr. Carlos Lorca Tobar 999, 8380456, Santiago, Chile.
Annals of intensive care
|December 20, 2023
概括
相对辅助呼吸 (PAV+) 和神经调整的呼吸辅助 (NAVA) 在ARDS患者中与压力支呼吸 (PSV) 相比,并不能防止悬浮,肺损伤机制. 悬浮升高的幅度与呼吸驱动和呼吸力度相关.
科学领域:
- 机械通风机械通风机械通风
- 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:
- 悬浮,或内部气体再分配,是依赖于努力的肺损伤的潜在机制.
- 与压力支通风 (PSV) 相比,神经调节的呼吸辅助 (NAVA) 和比例辅助通风 (PAV +) 改善了患者-呼吸器同步.
- 与PSV相比,NAVA或PAV+是否可以防止悬浮发展仍然是未知的.
研究的目的:
- 在急性呼吸困扰综合征 (ARDS) 患者中,比较PAV+和NAVA与PSV期间的pendelluft的大小.
主要方法:
- 这是一项交叉试验,涉及20名ARDS患者接受NAVA,PAV+或PSV20分钟间隔,在可比的辅助水平.
- 评估悬浮幅度,呼吸驱动 (ΔPes 100毫秒) 和呼吸力 (PTPmin) 的评估.
- 使用重复测量,临时测试和混合效应模型进行统计分析.
主要成果:
- 尽管类似的潮体积,NAVA和PAV+显示出较高的呼吸驱动和鼓舞力,与PSV相比.
- 与PSV (8±6%) 相比,NAVA (12±7%) 和PAV+ (13±7%) 的升幅度显著更高.
- 悬浮升力大小与呼吸驱动和吸气力度有很强的相关性,独立于通风模式.
结论:
- 悬浮量与呼吸驱动和启发力度有关.
- 相对辅助模式 (NAVA,PAV+) 与PSV相比,在解决ARDS时不会阻止起.
- 这些发现强调了监测ARDS患者这些参数的重要性.
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