新生儿正压通风在不同通风速率上的呼吸指标:模拟研究
Ming Zhou1, Xiaohong Xi1, Pu Zhao1
1Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
Resuscitation plus
|January 31, 2025
概括
在新生儿复苏 (NR) 期间,使用T片复苏器 (TPR) 和自充袋 (SIB) 的更快的通风率导致潮体积较小,但最终呼吸压力 (PEEP) 更高. 分钟体积受到最小的影响.
科学领域:
- 新生儿复苏术 新生儿复苏
- 呼吸系统生理学 呼吸系统生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 有效的通风对于新生儿复苏至关重要.
- T-piece复苏器 (TPR) 和自充袋 (SIB) 是常见的NR设备.
- 有限的数据存在于这些设备的NR期间的呼吸指标.
研究的目的:
- 在NR训练期间使用TPR和SIB评估各种呼吸速率 (VR) 的呼吸指标.
- 在模拟的新生儿复苏场景中比较TPR和SIB的性能.
主要方法:
- 在NR培训课程期间的一项观察模拟研究.
- 参与者使用TPR和SIB在设定的压力和不同速度下进行正压通风.
- 使用新生儿活跃肺模型 (NALM) 记录呼吸指标,并在三个VR组 (Slow,Std,Fast) 进行分析.
主要成果:
- 一般来说,TPR导致通风速度比SIB慢.
- 与SIB相比,TPR显示出较高的阳性末尾呼气压力 (PEEP),较小的潮体积 (Tv) 和分钟体积 (MV) (p <0.05).
- 对于这两种设备来说,更快的VR与更高的PEEP和更小的TV相关,但VR之间的MV差异并不显著.
结论:
- 增加的通风速率 (VR) 与潮体积 (Tv) 相反相关,对于T片复苏器 (TPR) 和自充袋 (SIB) 两种T片复苏器 (TPR) 和自充袋 (SIB) 均与正极呼气压力 (PEEP) 相反相关.
- 超过60bpm的TPR呼吸速率可能导致过度PEEP,可能会在临床实践中引起安全问题.
- 对于TPR和SIB设备,改变VR对分钟体积的影响是最小的.
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