呼吸功能测试指导通风机模式转换在先天性隔膜的呼吸功能测试
Sasagu Kimura1,2, Katsuaki Toyoshima1, Tomoyuki Shimokaze1
1Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
患有先天性隔膜的婴儿的高呼吸阻力表明他们对常规机械通风 (CMV) 的反应比高频振荡通风 (HFOV) 更好. 呼吸功能测试有助于定制呼吸机设置,以获得更好的结果.
科学领域:
- 新生儿医学 新生儿医学
- 儿科肺病学 儿科肺病学
- 关键的护理关键的护理
背景情况:
- 先天性隔膜 (CDH) 的管理通常涉及传统的机械通风 (CMV) 或高频振荡通风 (HFOV).
- HFOV通常是一种救援疗法,但这项研究探讨了其在初始管理中的使用.
- 术前挑战测试和呼吸功能测试被用来指导呼吸器策略的选择.
研究的目的:
- 为了比较最初用CMV转换管理的组与那些更喜欢HFOV的组之间的患者特征.
- 评估呼吸功能测试在指导对CDH患者的呼吸器选择中的有用性.
主要方法:
- 在CMV转换之前和之后,对呼吸机设置和血液气体的回顾性评估.
- 在试验中进行呼吸功能测试,包括呼吸系统符合性 (Crs) 和耐药性 (Rrs),用于CMV转化.
- 在CMV转换和HFOV偏好的群体之间比较患者人口统计和生理参数.
主要成果:
- 两组之间妊娠年龄,出生体重或肺部面积与头部周长比没有显著差异.
- 在CMV转化组中,呼吸系统阻力 (Rrs) 的中位数显著更高 (467对327cmH2O·kg/L/s,p=0.045).
- 血液气体和通风器参数的变化在两组中都显示出了有利的反应,平均气道压力,二氧化碳水平和氧化指数的具体趋势.
结论:
- 呼吸功能测试,特别是Rrs,对于优化CDH的呼吸器设置是有价值的.
- 具有较高Rrs值的患者在转化为CMV时表现出更好的反应.
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