不同步的隔膜收缩会损害机械通风患者的隔膜功能
Benjamin Coiffard1, Jose Dianti2,3, Irene Telias2,3,4
1Department of Respiratory Medicine, Aix-Marseille University, APHM, Hôpital Nord, Marseille, France.
Critical care (London, England)
|April 2, 2024
概括
机械通风期间的异步隔膜收缩会损害隔膜的功能. 这项研究发现,长时间的异步负荷,通常是由呼吸机异步引起的,逐渐恶化隔膜神经肌肉合.
科学领域:
- 临界护理医学 临界护理医学
- 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:
- 临床前研究表明,机械通风期间异步膜活动可能导致急性膜功能障碍.
- 了解隔膜收缩负荷的变化对于预防通风器引起的隔膜损伤至关重要.
研究的目的:
- 在机械通风过程中量化隔膜收缩负荷的变化.
- 为了确定异步的隔膜收缩与隔膜功能障碍的发展是否相关.
主要方法:
- 每小时的气道流量,压力和隔膜电活动 (EDI) 的记录从45名入侵性机械通风患者收集到,长达7天.
- 根据神经启发持续时间和呼吸器循环后的循环,确定了异步的吸入后隔膜负荷.
- 每天使用神经肌肉合 (NMC) 评估隔膜功能.
主要成果:
- 超过4500个小时的数据显示,在51%的时间里,Edi是低或不存在的.
- 不同步的吸入后负载发生在13%的小时,与反向触发和过早循环显著相关.
- 不同步负荷的持续时间和强度与隔膜NMC的逐渐减少相关.
结论:
- 机械通风期间异步的隔膜收缩会对隔膜功能产生负面影响.
- 促进异步负载的风扇设置会随着时间的推移导致隔膜功能障碍.
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