[关于在侵入性机械通风中估计动态内在正极呼气压力的一种方法的理论研究]
1Department of Critical Care Medicine, Dongying People's Hospital, Dongying 257091, Shandong, China.
Zhonghua wei zhong bing ji jiu yi xue
|February 26, 2024
概括
一种新的方法估计了使用呼气流量-时间曲线在机械呼吸患者的动态内在正极端呼气压 (PEEPi). 这种技术可以实时测量PEEPi,从而改善呼吸支.
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
- 机械通风机械通风机械通风
背景情况:
- 侵入性机械通风对于呼吸衰竭管理至关重要.
- 精确监测正极呼气压 (PEEP) 是至关重要的.
- 动态内在正极呼气压 (PEEPi) 可以使通风复杂化.
研究的目的:
- 引入一种简单的实时方法来测量动态PEEPi.
- 通过在侵入性机械通风期间的案例研究来验证该方法.
主要方法:
- 使用了一位呼吸不完整的患者的呼气流动时间曲线分析.
- 定义的关键时间点 (T0,T1,T2,T3) 和到期量 (S1,S2,S3).
- 使用呼吸系统合规性 (C) 和压力/体积变化计算PEEPi.
主要成果:
- 计算动态PEEPi (PEEPi1和PEEPi2) 的两个估计的衍生公式.
- PEEPi1 = PEEP + (S3-S1)/C. 这样就没有问题了.
- PEEPi2 = PEEP + (S3-S2) /C. 这样就没有问题了.
结论:
- 过期流量-时间曲线延长方法可以理论上实时估计动态PEEPi.
- 这种方法适用于在机械呼吸过程中出现不完全呼气的患者.
- 该技术已在中国获得专利 (ZL 2020 1 0391736.1).
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