在机械通风过程中监测呼吸肌肉的劳动力
Julien P van Oosten1, Evangelia Akoumianaki2,3, Annemijn H Jonkman1
1Intensive Care Volwassenen, Erasmus Medical Center, Rotterdam, The Netherlands.
Current opinion in critical care
|November 19, 2024
概括
在机械通风过程中监测呼吸肌肉的努力至关重要. 各种非侵入性和侵入性工具有助于评估呼吸和呼气肌肉的努力,以保护肺部.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 机械通风机械通风机械通风
背景情况:
- 呼吸力度监测对于优化机械通风至关重要.
- 精确评估呼吸道肌肉的努力是防止呼吸机引起的肺损伤的关键.
- 了解吸气和呼气肌肉的贡献至关重要.
研究的目的:
- 审查呼吸努力的基本生理概念.
- 概述监测吸入和呼出肌肉劳动力的方法.
- 讨论呼吸肌力劳动力评估的临床影响.
主要方法:
- 审查关于呼吸肌力劳动力监测的现有文献.
- 讨论侵入性方法,如食道压力 (Pes) 测量.
- 探索非侵入性查工具,如闭塞压力 (P0.1,Pocc) 和启发性持有机动.
- 考虑表面电肌图和胃压力监测.
主要成果:
- 消化管压力 (Pes) 仍然是量化呼吸肌肉努力的黄金标准.
- 非侵入性工具,如呼吸道阻塞压力 (Pocc),在评估高精力和肺压力方面表现有前途.
- 鼓舞性肌肉努力可以评估,但可靠的测量是具有挑战性的.
- 呼吸道肌肉激活在重症患者中很常见,并且会影响劳动力解释.
- 在未来,机器学习可能会自动化床边呼吸力度监测.
结论:
- 有一系列的工具,从非侵入性到侵入性,可用于监测呼吸肌肉的劳动力.
- 有效的监测有助于制定肺部和呼吸道肌肉保护性通风策略.
- 精确评估呼吸力度对于机械通风患者的结果至关重要.
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