压力控制通风与体积控制通风在腹腔镜外科手术:一个叙述性审查
Urvi Sawant1, Jayshree Sen1, Sheetal Madavi1
1Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus
|September 16, 2024
概括
与体积控制通风 (VCV) 相比,压力控制通风 (PCV) 在腹腔镜手术期间可以提供更好的气道压力和氧化. 然而,VCV确保了一致的潮体积,使得选择取决于患者和手术因素.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
- 手术创新 在外科创新.
背景情况:
- 腹腔镜手术对机械通风提出了独特的挑战,原因是腹腔内压力增加.
- 音量控制通风 (VCV) 和压力控制通风 (PCV) 是具有明显生理效应的常见模式.
研究的目的:
- 在腹腔镜手术的背景下比较VCV和PCV的安全性和有效性.
- 审查当前的文献,并提供对最佳通风策略的见解.
主要方法:
- 从184个初始出版物中选择的9项研究的系统综述.
- 在研究选择中应用严格的纳入和排除标准.
主要成果:
- PCV显示出降低高峰气道压力的潜力,降低风险的volutrauma和barotrauma,并改善氧化.
- VCV确保了精确的潮体积传递,这对于稳定的二氧化碳水平至关重要,但可能导致更高的气道压力.
- 一般来说,PCV提供了更好的呼吸机制管理,而VCV的一致传递在特定情况下是有益的.
结论:
- 在PCV和VCV之间做出选择应该是个性化的,考虑到麻醉团队的专业知识,患者的状态和手术需求.
- 先进的监测和多式麻醉,包括肌肉松剂和量身定制的流体管理,对于优化结果至关重要.
- 在管理氧化和气道压力方面,PCV似乎更有利,但在细化腹腔镜外科手术中的通风策略方面,持续的研究至关重要.
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