在Fontan患者中使用Sniff和口腔正气压装置 (Sniff-PEP) 增强双相呼吸
Shawn Shaji1, Muhammad A Zafar2, Adam Christopher1
1Department of Pediatrics, Heart Institute, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA.
Pediatric cardiology
|July 19, 2024
概括
口服正气压 (oPEP) 通过嗅口呼吸改善了Fontan循环中的流速. 这项试点研究表明,oPEP可能会提高Fontan患者的血液循环,这需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗器械 医疗器械
背景情况:
- 喷泉循环在控制肺血流和心脏输出方面提出了独特的挑战.
- 双相通风策略在改善Fontan患者的血液动力学参数方面表现有前途.
- 口服正气压 (oPEP) 装置,当与嗅觉呼吸 (Sniff-PEP) 一起使用时,可以模仿双相通风.
研究的目的:
- 为了评估Sniff-PEP对Fontan流速和心脏输出的影响.
- 评估一个月的OPEP装置干预在Fontan循环的个体中的可行性和初步效果.
主要方法:
- 一项试点,前性研究,涉及15名具有Fontan循环的受试者.
- 参与者使用了oPEP设备10-15分钟,每天3-4次,一个月.
- 心声图被用来测量基线和随访时的流速和心脏输出;生活质量也被评估.
主要成果:
- 观察到肝静脉流速 (p=0.003) 和肺动脉流速 (p=0.01左侧,p=0.04右侧) 的统计学显著增加.
- 慢性使用oPEP的平均化梯度显示不显著下降 (p=0.14).
- 急性使用oPEP装置表明,在Fontan循环的多个区域,流速增加.
结论:
- 使用Sniff-PEP的oPEP设备治疗,在Fontan循环的关键区域急剧增加了流速.
- 这些发现表明oPEP在改善Fontan患者的血液动力学方面具有潜在的益处.
- 需要进一步的长期研究才能充分了解这种干预的持续效应和临床影响.
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