超作为支气管镜肺体积减小的绝对排除标准
Jonathan W Burgei1, Katie Alsheimer1, Julia Lantry1
1Robert Packer Hospital, Guthrie Clinic, Pulmonary, Critical Care Department, USA.
Respiratory medicine case reports
|September 19, 2024
概括
支气管镜肺体积减小现在可以包括超患者. 一个案例研究表明,平均体积保证压力支 (AVAPS) 帮助患者获得了该程序的资格,挑战了早期的排除标准.
科学领域:
- 肺部病理学 肺部病理学
- 呼吸系统医学 呼吸系统医学
- 干预性支气管镜检查是一种干预性支气管镜检查.
背景情况:
- 支气管镜肺体积减小 (BLVR) 旨在通过创建atelectasis来改善肺功能.
- 从历史上看,由于担心气体交换恶化的担忧,高头 (升高的PCO2) 将患者排除在BLVR之外.
研究的目的:
- 介绍一个病例,其中一个超患者成为符合BLVR.
- 探索非侵入性通风策略在管理BLVR候选症高头症方面的潜力.
主要方法:
- 一名患有高头症的患者,最初不符合BLVR的条件,接受了非侵入性通风治疗.
- 患者接受了双层正气道压力 (BiPAP) 通风,但未能足够降低PCO2.
- 随后,启动了平均体积保证压力支 (AVAPS) 通风,成功降低了PCO2以满足BLVR标准.
主要成果:
- AVAPS使以前被排除在外的超患者有资格获得BLVR.
- 这一案例表明,先进的通风技术可以扩大对肺体积减小手术的资格.
结论:
- 在适当的呼吸道管理下,头过高可能不是BLVR的绝对禁忌.
- 在被考虑为BLVR的患者中,AVAPS可以成为管理PCO2的有效工具,可能会扩大可以受益的患者群体.
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