在术后心脏外科手术患者的静态肺部符合性和输出失败之间的关系
Thais Bento Rudge Ramos1, Luciana Castilho Figueiredo1, Luiz Claudio Martins1
1Universidade Estadual de Campinas, Campinas, SP - Brasil.
Arquivos brasileiros de cardiologia
|February 29, 2024
概括
低静态肺部顺应,特别是低于41ml/cmH2O,显著增加心脏手术后输出失败的风险. 这一发现有助于预测术后患者的成功输出管.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 临界护理医学 临界护理医学
背景情况:
- 静态肺部服从至关重要,但在心脏手术后经常受损.
- 遵守障碍可能导致呼吸和输出失败.
- 这种关系在快速排卵协议中未得到充分探索.
研究的目的:
- 为了评估心脏手术后的静态肺部合规性.
- 在快速治疗的患者中,将降低的遵守与输出失败相关联.
主要方法:
- 在机械呼吸机上使用最小方程拟合软件评估静态肺部合规性.
- 监测了77名接受心脏手术和心肺旁路手术的患者.
- 观察到需要在输出管后48小时内重新输入管.
主要成果:
- 24.51%的患者经历了输出失败.
- 下静态肺部顺应与输出失败有显著的关联 (p<0.001).
- 符合值<41ml/cmH2O预测了更高的故障概率 (ROC分析,p<0.001).
结论:
- 静态肺部顺应低于41ml/cmH2O是一个显著的预测器的输出失败.
- 这一指标可以帮助识别心脏手术恢复中的高风险患者.
- 早期识别可能会改善患者的治疗结果,并降低再输管率.
相关概念视频
Endotracheal Tube Extubation
661
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
661
Endotracheal Intubation II: Nursing Management
628
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
628
Acute Respiratory Failure-III
184
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
184
Endoscopic Studies II: Thoracocentesis
258
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
258
Pressure Relationships in Thoracic Cavity
2.3K
Breathing, otherwise known as pulmonary ventilation, is the process of air movement into and out of the lungs. The main mechanisms propelling pulmonary ventilation are atmospheric pressure (Patm), intra-pulmonary (Ppul ) or intra-alveolar pressure (Palv) within the alveoli, and intrapleural pressure (Pip) within the pleural cavity.
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...
2.3K
Factors Affecting Pulmonary Ventilation
1.4K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.4K


