在大手术后的患者中,基于电阻断层扫描的通风模式
Hirofumi Iwata1, Takeshi Yoshida1, Taiki Hoshino1
1Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan; and.
American journal of respiratory and critical care medicine
|February 12, 2024
概括
手术后的患者表现出不同的肺呼吸模式. 通过电阻断层扫描 (EIT) 识别的不均模式与增加的肺部并发症和更长的重症监护室停留有关.
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
- 医疗成像医学成像
背景情况:
- 全身麻醉和机械通风可以破坏肺空气分配.
- 了解术后通风模式对于预测临床结果至关重要.
研究的目的:
- 使用电阻断层扫描 (EIT) 在术后患者中识别明显的通风模式.
- 评估这些通风模式与术后肺部并发症 (PPC) 以及其他临床结果之间的关联.
主要方法:
- 预期招募128名高风险成人术后患者,接受机械呼吸.
- 利用EIT将通风模式分为三个表型:腹部占主导地位,均和背部占主导地位.
- 监测PPCs,机械通风和氧气的断奶时间,以及ICU停留时间.
主要成果:
- 确定了三个通风表型:均 (41%),腹部占主导 (32%) 和背部占主导 (27%).
- 与同质模式相比,在腹部或背部占主导地位的患者中观察到更高的PPC得分.
- 不均的模式 (腹部/背部占主导地位) 与更长的机械通风断奶时间,使用氧气的持续时间和重症监护室停留时间有关.
结论:
- 在ICU入院时,EIT检测到的不均的肺通风模式与增加的PPC相关.
- 这些模式还预测了机械通风和氧气支持的延迟断奶.
- 来自EIT的通风表型为术后患者提供了有价值的预后信息.
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