适应式压力控制-持续强制通风与体积控制-持续强制通风:与启动,维护和调整相关的因素
Linh N Tran1, Jared E Rosen2, Alex K Pearce3
1Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, School of Medicine, La Jolla, California. Lit004@ucsd.edu.
Respiratory care
|August 6, 2024
概括
适应式压力控制-持续强制通风 (APC-CMV) 在ICU中很常见. 这项研究发现,与体积控制-持续强制通风 (VC-CMV) 相比,APC-CMV的使用导致了更多的日常呼吸器设置变化,而镇静没有任何好处.
科学领域:
- 临界护理医学 临界护理医学
- 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:
- 适应性压力控制-持续强制通风 (APC-CMV) 广泛用于重症监护室 (ICU).
- 本研究将APC-CMV与传统的体积控制-持续强制通风 (VC-CMV) 进行比较.
- 它检查了影响这些通风机模式启动,维护和调整的因素.
研究的目的:
- 为了比较APC-CMV与VC-CMV的利用和结果.
- 确定与选择APC-CMV或VC-CMV相关的因素.
- 评估每个模式的通风器设置调整和镇静要求.
主要方法:
- 从一个学术ICU电子健康记录的回顾性分析.
- 根据机械通风时间的最高比例来确定大多数通风器模式.
- 多变量逻辑回归和威尔科克森等级总和测试用于分析.
主要成果:
- 在1213名受试者中,68%的受试者开始使用APC-CMV,占大多数模式的62%.
- 与VC-CMV相比,APC-CMV多数模式对象的每日呼吸器设置变化 (1.1比0.8,P<.001) 更多.
- 两种模式之间没有观察到镇静剂药物使用的显著差异.
结论:
- 在医疗ICU中,APC-CMV被广泛使用.
- 与VC-CMV相比,APC-CMV的使用与每日呼吸器设置调整的增加有关.
- 在减少设置调整或减少镇静方面,APC-CMV没有表现出优势.
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