自发呼吸试验期间的通风分布预测了摆脱机械通风的情况:VISION研究
Vorakamol Phoophiboon1,2,3, Antenor Rodrigues1,2, Fernando Vieira1,2
1Unity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
在自发呼吸试验 (SBT) 中,电阻断层扫描 (EIT) 可以预测从机械通风中解放出来. 较大的腹部到背部通风差异表明释放失败的风险更高.
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
- 医疗成像医学成像
背景情况:
- 预测机械通风 (MV) 的成功断奶仍然是一个临床挑战.
- 电阻断层扫描 (EIT) 提供非侵入性的区域通风数据.
- 对于预测MV解放结果,EIT可能会提供有价值的见解.
研究的目的:
- 确定自发呼吸试验 (SBT) 期间区域通风分布是否可以预测早期和成功的MV释放.
- 调查EIT在SBT期间评估通风模式的实用性,以预测断奶成功.
主要方法:
- 在SBT期间,患者接受了EIT监测.
- 分析了从腹部到背部的通风差异.
- 释放成功被定义为在24小时内成功输出输出管,并在7天内没有重新输入管.
- 一个培训队伍被用于发现,其次是一个验证队伍.
主要成果:
- 在98名患者中,有85人通过了SBT,但只有40人取得了快速释放的成功.
- 与失败组相比,在成功释放的患者中观察到一贯较小的绝对腹部到背部通风差异 (p < 0.0001).
- 在SBT5分钟的绝对差异>20%预测释放失败,在验证队列中具有71%的灵敏度和78%的特异性.
结论:
- 在SBT期间,通过EIT测量的显著腹部到背部通风差异可以帮助识别患有释放失败风险的患者.
- 来自EIT的通风分布可以提高预测机械通风成功断奶的准确性.
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