呼吸机在长期机械通风中断奶-一篇叙述性评论
Tamás Dolinay1,2, Lillian Hsu1,2, Abigail Maller1,2
1Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
Journal of clinical medicine
|April 13, 2024
概括
长时间的机械通风 (MV) 影响10%的患者,越来越多的患者需要在ICU后获得专业护理. 断奶策略的进步为长期呼吸器支持提供了摆脱长期呼吸器支持的希望.
科学领域:
- 临界护理医学 临界护理医学
- 肺部病理学 肺部病理学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 长时间的机械通风 (MV) 影响了一大批患者,估计占所有MV病例的10%.
- 与急性护理相比,在重症监护室 (ICU) 设置中,对长期MV患者的护理理解较少.
- 这一患者群通常包括医疗复杂,老年人和社会经济弱势的个体,经常在生命末期.
研究的目的:
- 审查最近对需要长期机械通风的患者的断奶策略的进展.
- 介绍与这些新型断奶方法相关的结果.
- 提供关于长期MV所带来的多方面的护理挑战的见解.
主要方法:
- 文献综述,重点关注长期机械通风断奶的最新研究和临床实践.
- 结果分析来自各种后ICU和专业护理机构的结果数据.
- 综合有关该患者群体护理复杂性的信息.
主要成果:
- 超过50%的被认为在ICU中不可脱离的患者可以在后急性环境中从MV中获释.
- 家庭通风越来越多地被利用,除了传统的通风机奶设施和熟练的养老院外.
- 最近在断奶策略方面的进展正在改善长期MV患者的治疗结果.
结论:
- 后急性护理设置在释放患者从长时间的机械通风中发挥着至关重要的作用.
- 创新的断奶策略对于管理不断增长的人口至关重要,需要扩展的呼吸系统支持.
- 解决长期MV患者护理的复杂性需要采用多学科的方法,考虑患者的特定需求和不断变化的护理模式.
相关概念视频
Mechanical Ventilation II: Invasive Ventilation
131
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
131
Mechanical Ventilation I: Indication and Settings
338
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
338
Mechanical Ventilation III: Noninvasive Ventilation
110
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
110
Ventilatory Modes
137
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
137
Tracheostomy Decannulation
159
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
159
Endotracheal Tube Extubation
639
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....
639


