在ARDS患者的模拟机械呼吸过程中,呼吸机设置对机械功率的影响
Mohamad F El-Khatib1, Salah M Zeinelddine2, Thuraya H HajAli1
1Department of Anesthesiology and Pain Medicine, American University of Beirut, Beirut, Lebanon.
Respiratory care
|March 27, 2024
概括
减少潮体积 (VT) 是在ARDS患者机械通风期间保持安全机械功率 (MP) 水平的最有效方法. 建议使用较低的VT和较高的呼吸频率进行保护性通风.
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
- 生物医学工程 生物医学工程
背景情况:
- 机械功率 (MP) 是一个关键因素,影响了接受机械通风的患者的结果.
- 潮体积 (VT),呼吸频率和PEEP是影响MP输送的关键呼吸器设置.
- 了解个人设置如何影响MP对于保护性通风策略至关重要.
研究的目的:
- 在模拟ARDS中确定最有效的机械通风设置,以保持安全的MP水平.
- 为了比较不同通风模式 (VCV-CF,VCV-下降,PCV) 在控制MP.的有效性.
- 为了确定最佳的VT和呼吸频率组合,在ARDS严重程度范围内保护MP.
主要方法:
- 使用一个交互式数学模型模拟在VCV和PCV模式下通风机输出.
- 模拟轻度,中度和重度ARDS的计算MP.
- 独立调整VT,呼吸频率和PEEP以保持MP≤17J/分钟.
- 确定了MP的最佳VT-呼吸频率组合 = 17J/分钟.
主要成果:
- 使用恒定吸入流 (VCV-CF) 的音量控制通风系统始终产生最低的MP.
- 压力控制通风 (PCV) 导致了最高的MPs.
- 减少潮体积 (VT) 是降低MP的最有效策略.
- 最佳的VT-呼吸频率组合因ARDS严重程度而有所不同,通常建议VT较低,频率更高.
结论:
- VCV-CF是最大限度地减少MP的最有效模式.
- 减少潮体积 (VT) 是实现安全和保护MP水平的主要方法.
- 实施低VT和更高呼吸频率的呼吸系统策略对于ARDS患者来说至关重要,以保持低MP.
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