流量优化的压力控制通风-保证体积 (PCV-VG) 对术后肺部并发症的影响:一项联合研究
Ting Ting Sun1, Ke Xin Chen1, Yong Tao1
1Department of Anesthesia Operation, The First People's Hospital of Shuangliu District (West China Airport Hospital of Sichuan University), No.120, Chengbei Street, Dongsheng Street, Shuangliu District, Chengdu, 610200, China.
Journal of cardiothoracic surgery
|July 8, 2024
概括
在单肺通风 (OLV) 期间优化吸气流速可显著减少胸部手术患者的术后肺并发症 (PPC). 这种方法增强了肺动态的遵守,并改善了患者的治疗结果.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 术后肺部并发症 (PPCs) 在单肺通风 (OLV) 后是胸部外科手术的一个重大问题,影响患者的预后.
- 有效地管理通风策略对于减轻这些风险和改善患者康复至关重要.
研究的目的:
- 调查优化吸气流速对OLV胸部手术患者PPC发生率的影响.
- 评估流速优化对OLV期间呼吸机制和氧化的影响.
主要方法:
- 一个随机对照试验,涉及108名选择性胸部手术患者,比较固定的吸入呼吸比率 (1:2) 与优化的吸入呼吸流速.
- 在多个时间点测量了关键的呼吸参数 (峰值,Pplat,PETCO2,Cdyn,呼吸速率,氧度) 和氧化指数 (PaO2:FiO2).
- 肺部超声波得分 (LUS),骨质疏散和PPCs在术后进行了评估.
主要成果:
- 优化吸气流速组与对照组 (16.98%) 相比,PPC (3.64%) 的流行率明显较低.
- 在优化组中观察到动态肺顺应 (Cdyn) 和氧化指数的显著改善.
- 在治疗组中,C反应性蛋白 (CRP) 和炎症细胞水平降低.
结论:
- 优化吸气流量,特别是与压力控制通风量保证 (PCV-VG) 模式相结合时,是减少OLV患者PPC的有效策略.
- 这种通风策略增强了肺动态遵守,改善了氧化,有助于改善术后结果.
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