在机械通风的儿童中,与呼吸系统携带相关的反向触发
Robert G T Blokpoel1, Ruben B R Brandsema2, Alette A Koopman2
1Department of Paediatrics, Division of Paediatric Intensive Care, Beatrix Children's Hospital, University Medical Center Groningen, P.O. Box 30.001 9700 RB, Groningen, CA 62, the Netherlands. r.g.t.blokpoel@umcg.nl.
Respiratory research
|March 26, 2024
概括
机械通风儿童的逆触发不是一个单一的现象,而是一个频谱. 了解它的机制,比如呼吸引入,会影响患者的结果和通风持续时间.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 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:
- 机械通风过程中反向触发 (RT) 的确切原因尚不清楚.
- 呼吸引入通常与RT混为一谈,或与RT交替使用.
- 描述RT及其与儿科患者呼吸系统带的联系至关重要.
研究的目的:
- 在儿科患者中区分和描述逆触发 (RT).
- 为了研究RT与呼吸系统携带之间的关系.
- 分析RT对机械通风参数和患者结果的影响.
主要方法:
- 对侵袭性通风儿童 (<18岁) 的现有生理数据的二次分析.
- 使用呼吸机波形,食道跟踪和腹膜电肌学.
- 识别和分类的呼吸被引进或非引进RT.
主要成果:
- 反向触发在50%的记录中被发现 (12%被引入,38%没有被引入).
- 非引入的RT与增加的潮体积 (双触发) 和较低的呼吸变异性有关.
- 与携带相关的RT患者经历了更短的机械通风持续时间和PICU停留.
结论:
- 反向触发代表了一系列的临床表现,而不是单一的事件.
- 不同的RT机制对接受呼吸的儿童有不同的后果.
- 对RT机制的进一步研究可以优化机械通风策略.
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