持续按需的隔膜神经刺激以防止机械通风期间隔膜不活动:一期临床试验 (STIMULUS)
Idunn S Morris1,2,3,4, Thiago Bassi5, Catherine A Bellissimo6
1University of Toronto, Department of Physiology, Toronto, Ontario, Canada.
概括
隔膜神经刺激是一种可行的方法,可以在机械通风期间保持隔膜活动,防止不活动和潜在的伤害. 这种方法可以确保隔膜功能,即使没有患者的呼吸驱动.
科学领域:
- 关键护理医学 关键护理医学
- 神经肌肉生理学 神经肌肉生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 侵入性机械通风可以导致隔膜不活,增加肺和隔膜损伤的风险.
- 这种不活动与危急病患者的临床结果较差有关.
研究的目的:
- 评估机械通风期间持续的,按需的隔膜神经刺激的可行性和安全性.
- 在缺乏自发呼吸驱动的患者中,保持隔膜活动至少24小时.
主要方法:
- 一个单一中心的第一期临床试验,涉及20名接受机械通风的患者.
- 通过静脉输入的隔膜神经刺激与机械呼吸同步进行.
- 干预持续到自发呼吸试验或长达七天,重点关注前24小时的安全性和可行性.
主要成果:
- 在接受该程序的19名患者中,隔膜神经刺激在100%成功启动.
- 在95%的患者中,在最初的24小时内,超过50%的被动机械通风小时保持了目标膜活动.
- 这项干预措施耐受性良好,隔膜活动维持了100%的时间,在七天的时间里没有呼吸驱动.
结论:
- 持续的按需隔膜神经刺激辅助机械通风是一种可行的干预措施.
- 这种方法有效地防止了需要机械通风的患者的隔膜不活.
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