对于个性化连续延伸压力机动的振荡计:在极度早产婴儿的观察性研究
Chiara Veneroni1, Raffaele L Dellacà2, Erik Küng3
1TechRes Lab, Department of Electronics, Information and Biomedical Engineering (DEIB), Politecnico di Milano University, Via G. Colombo 40, Milan, 20133, Italy.
Respiratory research
|January 4, 2024
概括
呼吸反应率 (Xrs) 为优化早产婴儿高频振荡通风 (HFOV) 设置提供了超出氧和的宝贵见解. 这种非侵入性措施有助于肺部招募和持续膨胀压力 (CDP) 定位.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 儿科重症监护中心儿童重症监护中心
背景情况:
- 高频振荡通风 (HFOV) 需要精确的肺部招募和持续扩张压力 (CDP) 定位,以确保在早产婴儿中有效.
- 周围氧和 (SpO2) 在优化CDP方面受到限制,需要进行替代的非侵入性床边测量.
- 通过振荡计测量10 Hz的呼吸反应率 (Xrs) 反映了肺体积招募和组织应变,Xrs的增加表明招募的改善.
研究的目的:
- 在接受HFOV作为主要治疗的极度早产婴儿中,在SpO2驱动的CDP优化过程中调查CDP和Xrs之间的关系.
- 通过氧化确定的最佳CDP (CDP_Opt_SpO2) 与CDP进行比较,该CDP在肺部招募机动 (CDP_Xrs) 的除气肢过程中产生最大Xrs.
主要方法:
- 一项前性观察性研究,涉及极早产婴儿 (怀孕28周前出生) 接受SpO2引导的肺部招募.
- 在HFOV期间在CDP的各个步骤同时记录SpO2和Xrs.
- 将CDP_Opt_SpO2与CDP_Xrs进行比较,以评估两种方法之间的相关性和一致性.
主要成果:
- 在40名被研究的婴儿中,96%的测量结果被很好地容忍和可靠.
- 在通货膨胀期间,Xrs通常下降,在通货膨胀期间增加,婴儿的反应异质.
- CDP_Opt_SpO2和CDP_Xrs显示出高相关性 (ρ = 0.71,p < 0.001),但在40名婴儿中30名婴儿有显著差异,表明最佳设置中的潜在差异.
结论:
- 在Xrs的变化提供了对SPO2的补充信息,用于评估早产婴儿在HFOV期间的肺部招募.
- 需要进一步的研究来完善使用Xrs测量的肺部招募策略和CDP设置.
- Xrs测量可能提供了一个比单独的SpO2更细致的方法来优化肺体积.
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