肺抵抗 - 但不符合 - 损害P0.1和最大吸入压力测量
Mickael Lescroart1, Florian Blanchard2, Jean-Michel Constantin2
1Service de Médecine Intensive et Réanimation Brabois, CHRU Nancy, Pôle Cardio-Médico-Chirurgical, Université de Lorraine, 54511 Vandœuvre-lès-Nancy, France; INSERM U1116, Faculté de Médecine, Vandœuvre-lès-Nancy, France; Université de Lorraine, Nancy, France.
肺抵抗,而不是遵守,影响了机械通风期间的呼吸驱动和吸气肌功能测量. 这一发现凸显了使用闭塞机动来监测患者的潜在陷.
科学领域:
- 呼吸系统生理学 呼吸系统生理学
- 关键护理医学 关键护理医学
- 医疗器械技术 医疗器械技术
背景情况:
- 床边工具对于评估机械通风患者的吸气肌功能和驱动器至关重要.
- 使用遮蔽机动,但有未充分探索的局限性.
- 了解这些局限性对于准确的患者评估至关重要.
研究的目的:
- 评估呼吸系统符合性和抵抗性对P0.1和最大吸入压力 (MIP) 监测的影响.
- 在使用in-silico模型的不同固定吸入肌肉压力 (PMUS) 下评估这些参数.
主要方法:
- 使用主动伺服肺5000 (ASL-5000) 模拟呼吸条件.
- 应用固定的PMUS水平 (5,10,20cmH2O),具有抗性和合规性的挑战.
- 使用Dräger Evita Infinity V500呼吸机监控P0.1和MIP. 这是一个非常好的方法.
主要成果:
- 呼吸系统阻力增加显著影响了P0.1和MIP监测,导致低估.
- 呼吸系统的符合性对P0.1和MIP值的影响很小.
- 发现呼气阻力,而不是吸气阻力,会影响压力监测的准确性.
结论:
- 肺阻力,特别是呼吸阻力,会影响P0.1和MIP测量的准确性.
- 呼吸系统的符合性不会显著影响这些阻塞机动衍生的参数.
- 需要进行进一步的临床研究,以便在实践中完全定义闭塞机动监测的局限性.
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