在压力控制通风过程中,持续估计呼吸系统的符合性和气道阻力,而无需末端吸入阻塞
Yuqing Chen1, Yueyang Yuan2, Qing Chang3
1Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, No.241, West Huaihai Road, Shanghai, 200030, China. chenyqn1969@126.com.
BMC pulmonary medicine
|May 20, 2024
概括
在机械通风过程中,使用压力控制通风 (PCV) 和动态信号分析,在空气流阻塞不严重的情况下,可以准确评估呼吸机制. 这种方法可靠地估计呼吸系统的特性 (Crs和Raw).
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机
背景情况:
- 在机械通风过程中评估呼吸系统力学 (Cst) 需要零末吸气流,通常通过阻塞机动来实现.
- 这项研究调查了空气流阻塞对压力控制通风 (PCV) 过程中呼吸机制准确性的影响.
研究的目的:
- 为了评估在不同程度的空气流阻塞的情况下在PCV期间呼吸机机械性质估计的准确性.
- 评估动态信号分析对这些估计的影响.
主要方法:
- 使用模拟健康,ARDS和COPD模型的肺模拟器与汉密尔顿C3呼吸器一起使用.
- 压力控制通风 (PCV) 和体积控制通风 (VCV) 在不同的潮体积 (VT) 上应用.
- 呼吸机制被评估和校准使用虚拟抽取与呼气时间常数 (RCexp).
主要成果:
- 在ARDS模型中,在PCV期间,驱动压力 (DP) 显著增加.
- 峰值吸入流 (PIF) 和峰值呼出流 (PEF) 随着空气流阻塞的增加而下降,而DP,终端吸入流 (EIF) 和EIF/PIF%增加.
- 在健康和轻度阻塞模型中,以<5%的误差实现了呼吸系统符合性 (Crs) 和呼吸道阻力 (Raw) 的准确估计.
- 严重的阻塞导致Crs的低估和Raw的高估.
结论:
- 修改后的动态信号分析允许在没有严重空气流阻塞的患者在PCV模式下准确估计呼吸系统属性 (Crs和Raw).
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