两个通风方法的动态和静态合规性比较,潮体积为6和10毫升/公斤:随机临床试验
Mehryar Taghavi Gilani1, Alireza Bameshki1, Majid Razavi1
1Lung Disease Research Center, Department of Anesthesiology, Mashhad University of Medicine Sciences, Mashhad, Iran.
Medical journal of the Islamic Republic of Iran
|October 14, 2024
概括
在腹部癌症手术患者的潮体积并没有显著影响肺部遵守. 在机械通风过程中,6mL/kg和10mL/kg的潮体积都保持了类似的静态和动态肺部合规性.
科学领域:
- 麻醉学 麻醉学
- 肺部生理学 肺部生理学
- 手术重症监护手术重症监护
背景情况:
- 肺部顺应是一个关键的肺功能指标.
- 潮的体积显著影响了肺部的服从.
- 腹部癌症手术患者容易发生呼吸道并发症.
研究的目的:
- 在接受腹部癌症手术的患者中比较静态和动态的肺部顺应.
- 为了评估两种不同的潮体积 (6毫升/千克和10毫升/千克) 对肺部遵守的影响.
- 为了评估血液动力学稳定性和气道压力,在机械通风过程中使用不同的潮体积.
主要方法:
- 一项随机临床试验,涉及50名没有慢性疾病的成年患者 (20-65岁),接受腹部癌症手术.
- 随机分配患者接受机械通风,使用10毫升/千克潮体积 (8次呼吸/分钟) 或6毫升/千克潮体积 (14次呼吸/分钟).
- 测量包括呼气潮流量,气道压力峰值和平原,心率和血压,每15分钟进行两小时. 数据分析使用SPSS v.20与P<0.05被认为是显著的.
主要成果:
- 两组人群之间没有发现显著的人口差异.
- 静态和动态肺部合规性在6毫升/千克和10毫升/千克的潮体积组之间没有统计学上显著的差异.
- 虽然静态合规性略有下降,达到6毫升/千克,增加了10毫升/千克,但这种趋势在统计学上并不显著 (P = 0.32). 峰值/平原气道压力和血液动力学参数在两组中保持一致.
结论:
- 机械通风的潮体积为6毫升/公斤和10毫升/公斤,在接受腹部癌症手术的患者中,可以比较静态和动态的肺顺应.
- 在研究期间,这两种潮体积都没有在维持肺部顺应性或血液动力学稳定性方面表现出显著的优势.
- 这些发现表明,对于类似的患者群体,在这一范围内的潮体积选择具有灵活性,尽管可能需要进一步的研究.
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