胃压力监测揭示了与活跃过气有关的异常患者-通风器相互作用:一项回顾性观察性研究
Evangelia Akoumianaki1, Katerina Vaporidi1, Vaia Stamatopoulou2
1Department of Intensive Care, University Hospital of Heraklion, Heraklion, Crete, Greece; School of Medicine, University of Crete, Crete, Greece.
Anesthesiology
|May 16, 2024
概括
在通风患者中,活跃的呼吸会破坏患者与呼吸器的同步,导致对呼吸努力的误解. 监测胃压力对于准确评估和管理这些相互作用至关重要.
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
- 机械通风机械通风机械通风
背景情况:
- 在辅助机械通风中,患者-通风器异步是常见的.
- 呼气肌收缩对这种相互作用的影响仍然不太清楚.
- 这项研究研究了活跃过期在患者与呼吸机相互作用中的作用.
研究的目的:
- 为了确定活跃的到期是否会影响患者与呼吸机的相互作用.
- 描述与活跃过期相关的特定事件.
- 为了强调胃压力监测的重要性.
主要方法:
- 对入侵通风患者进行了回顾性观察性研究.
- 使用食道压力 (Peso) 和胃压力监测.
- 通过胃压力上升 (ΔPgas ≥ 1.0 cm H2O) 在呼气流过程中定义了活跃的呼气.
主要成果:
- 76名患者中有58名患者表现出活跃的过期 (中位数 ΔPgas = 3.4厘米 H2O).
- 活跃的过期与无效的努力,自动触发,多次触发和延长周期有关.
- 观察到增加了机械膨胀时间 (54%) 和潮体积 (25%).
- 在有活跃到期 (P < 0.05) 的患者中,观察到更高的呼吸力 (dPeso/dt).
结论:
- 活跃的到期显著损害了患者与呼吸机的相互作用.
- 胃压力监测对于正确识别和管理这些事件至关重要.
- 误解可能导致不适当的临床管理决策.
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