腹腔外科手术后肺体积和通风分布:高流量鼻与CPAP对比
Enrico Lena1, Lucia Comuzzi2, Milos Ajčević3
1Department of Anesthesia and Intensive Care, Cattinara Hospital, ASUGI, Trieste, Italy enrico.aj.lena@gmail.com.
Respiratory care
|May 14, 2024
概括
高流量鼻腔管 (HFNC) 疗法在100L/分钟有效地改善了空腹手术患者的肺部招募,类似于持续正气道压力 (CPAP). 这一发现为肥胖患者治疗术后肺部并发症提供了潜在的替代方案.
科学领域:
- 肺部和重症监护医学 肺部和重症监护医学
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 肥胖增加了术后肺部并发症的风险.
- 持续正气道压力 (CPAP) 用于急性呼吸衰竭.
- 高流量鼻腔管 (HFNC) 治疗是一种新兴的CPAP替代方案.
研究的目的:
- 为了比较HFNC和CPAP对气体交换,肺体积和通风分布的影响.
- 为了评估HFNC和CPAP在进行腹腔镜减肥手术的患者.
- 使用电阻断层扫描 (EIT) 来测量肺机械.
主要方法:
- 在15名腹部外科手术患者的顺序氧气治疗方案中.
- 干预措施包括空气引面罩,增量和减量HFNC流量 (40-100 L/分钟),以及CPAP (10厘米H2O).
- 主要结果:通过EIT改变终端呼气肺阻抗 (ΔEELI);次要结果:全球不均质 (GI) 指数,潮阻抗变化 (TIV),氧化和舒适度.
主要成果:
- 在CPAP (10厘米H2O) 和HFNC (100L/分钟),以及在HFNC流量下降期间,DEELI显著增加.
- 与基线和较低的HFNC流量相比,GI指数在HFNC 100 L/min和CPAP下降.
- 呼吸频率降低了HFNC在60和100L/分钟;没有发现氧化或舒适度的显著差异.
结论:
- 在100L/分钟的HFNC促进腹患者的术后肺部招募.
- 在HFNC的研究中,肺部招募和通风分布与CPAP (10厘米H2O) 相似.
- 在这种患者群体中,HFNC是一种可行的呼吸辅助替代方案.
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