在患有先天性心脏病的儿童中,与成功的输出管准备测试相关的因素
Andrew G Miller1,2, Jessica Brown2, Olivia Marshburn2
1Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina. Andrew.g.miller@duke.edu.
Respiratory care
|January 2, 2024
概括
在患有先天性心脏病的儿童中,输出管准备性测试 (ERT) 在下呼吸机支持下更成功. 协议应考虑使用死亡空间与潮体积的比率来确定ERT的资格.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心脏病学 心脏病学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 输出管准备测试 (ERT) 对于将患有先天性心脏病的儿童从机械通风中断奶至关重要.
- 有限的数据存在于机械通风参数影响成功的ERT在这个人群.
研究的目的:
- 在患有先天性心脏病的儿童中,确定与成功ERT相关的机械通风参数.
- 假设特定的通风器设置与ERT结果相关.
主要方法:
- 从质量改进项目的每日ERT评估的回顾性分析.
- 评估机械通风参数,包括模式,压力和比率.
- 衡量的主要结果是ERT成功,定义为成功的输出管.
主要成果:
- 分析了320名受试者的780个ERT; 58%的结果是成功的输出管.
- 通过ERT的速度与通风机模式,峰值吸气压,Δ压力,PEEP,平均气道压力以及死空间与潮体积比 (所有P<.001) 有显著差异.
- 增加的呼吸器支持 (更高的压力,PEEP,Δ压力和死亡空间与潮体积比率) 与ERT成功率的降低有关.
结论:
- ERT的成功与通风器支持水平有关,较低的支持与更高的成功率相关.
- 死亡空间与潮体积的比率是ERT成功的一个重要因素,建议在协议中使用它超过PEEP值.
- 患有先天性心脏病的患者,包括患有蓝色病变的患者,可以考虑ERT协议.
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