呼吸道肌肉功能对依赖呼吸机的患者断奶后果的贡献和演变
Sara Virolle1, Baptiste Duceau2, Elise Morawiec1
1Service de Médecine Intensive - Réanimation-SRPR, APHP, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013, Paris, France.
Critical care (London, England)
|December 19, 2024
概括
在长期断奶的患者中,呼吸道肌肉功能和四肢强度受损. 隔膜超声指数的改善和ICU所获得的弱点的减少与成功的断奶结果有关.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 康复医学 康复医学 康复医学
背景情况:
- 长时间的机械通风在气管切割患者提出了显著的断奶挑战.
- 了解呼吸道肌肉功能和四肢肌肉力量之间的相互作用对于断奶成功至关重要.
研究的目的:
- 为了研究长期断奶过程中呼吸肌功能和四肢肌肉力量的演变.
- 确定这些参数的变化与断奶成功之间的关联.
主要方法:
- 评估隔膜功能 (神经刺激,TFdi和EXdi的超声波) 和呼吸肌肉强度 (MIP,FVC).
- 使用医学研究理事会得分 (MRC) 测量四肢肌肉力量.
- 每周对依赖呼吸机的气管切除患者进行评估.
主要成果:
- 隔膜功能障碍是普遍存在的 (中位数Ptr,stim 5.5 cmH2O).
- 释放时MIP,Ptr,stim和EXdi的改善与完全断奶有关.
- 只有在成功断奶的患者中,MRC得分的改善才显著.
结论:
- 呼吸道和四肢肌肉的严重损伤在长时间的断奶中很常见.
- 改善的隔膜超声波指数和减少ICU获得的软弱与成功的断奶相关.
- 在ICU获得的软弱是影响断奶失败的可接受因素.
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