自动通风与传统通风对通风机械功率的影响 - 一个随机交叉临床试验
Laura A Buiteman-Kruizinga1,2, Ary Serpa Neto2,3,4,5,6, Michela Botta2
1Department of Intensive Care, Reinier de Graaf Hospital, Delft, the Netherlands.
PloS one
|July 30, 2024
概括
使用INTELLiVENT-Adaptive Support Ventilation的自动通风在重症患者中没有降低整体机械功率. 然而,它确实降低了侵袭性通风期间被动患者的机械功率.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统疗法 呼吸系统疗法
- 机械通风机械通风机械通风
背景情况:
- 机械功率是机械通风中的一个关键指标,反映了能量转移到呼吸系统并影响患者的结果.
- INTELLiVENT-自适应式支持通风是一种自动化模式,旨在通过调整通风器设置来最大限度地减少呼吸力度.
- 了解自动通风对机械功率的影响对于优化患者护理至关重要.
研究的目的:
- 为了比较INTELLiVENT-Adaptive支持通风提供的机械功率与重症患者的传统通风.
- 评估自动通风在减少呼吸工作方面的有效性.
- 确定可能受益于自动通风策略的患者子组.
主要方法:
- 一个多中心,随机交叉试验,涉及危急病患者,需要侵入性通风超过24小时.
- 患者被分配到连续3小时的自动或常规通风周期.
- 测量的主要结果是被动和活跃患者状态中的机械功率,其次要结果包括呼吸机设置.
主要成果:
- 在自动通风和传统通风 (15.8对16.1J/分钟) 之间没有观察到总体中位数机械功率的显著差异.
- 亚组分析显示,自动通风的机械功率显著降低,特别是在被动患者 (16.9对比19.0J/分钟,P<0.01).
- 自动通风没有显示活跃患者的机械功率有显著的减少.
结论:
- 在未经选择的重病侵入性通风患者中,INTELLiVENT-自适应性支持通风并没有降低整体机械功率.
- 机械功率的降低仅在被动患者小组中观察到.
- 可能需要进一步的研究来完善不同患者群体的自动通风策略.
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