从压力控制通风到神经调节的通风辅助的呼吸模式的变化通过电阻断层扫描进行评估
Marika Rahtu1, Inéz Frerichs2, Tobias H Becher2
1Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, and Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
神经调节呼吸辅助 (NAVA) 与压力控制呼吸 (PCV) 相比,早产婴儿的呼吸模式更为多样化. 然而,这种增加的变异性并没有系统地改变呼吸支期间的通风分布或静音空间.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 医学技术 医学技术 医学技术
背景情况:
- 神经调节呼吸辅助 (NAVA) 越来越多地用于早产婴儿的呼吸辅助.
- 之前的研究没有调查过从压力控制通风 (PCV) 过渡到NAVA期间的通风分布和呼吸模式.
- 了解这些变化对于优化新生儿呼吸系统策略至关重要.
研究的目的:
- 评估通风模式 (PCV与NAVA) 对早产婴儿的通风分布和呼吸模式的影响.
- 为了比较全球和区域的通风参数,通风中心 (CoVs),静音空间和PCV和NAVA之间的呼吸周期时间.
- 使用电阻断层扫描 (EIT) 评估通风的变化.
主要方法:
- 追溯分析了欧卢大学医院16名早产婴儿的EIT数据.
- 评估了在PCV和NAVA之间切换之前和之后的稳定1分钟通风记录.
- 主要终点:全球和区域通风 (ΔZ) 的变化;次要终点:冠状病毒,静音空间和周期时间.
主要成果:
- 与PCV相比,NAVA显示全球潮阻抗和呼吸周期时间的变异性明显更大 (p < 0.05).
- 叹息 (阻抗变化>2x平均呼吸) 在NAVA (5.1%) 期间比PCV (0.8%) 更频繁.
- 在平均全球/区域阻抗变化或两种模式之间的静音空间之间没有发现显著差异.
结论:
- 在侵袭性支持下,NAVA促进了早产婴儿的更可变的呼吸模式,而不是患者触发的PCV.
- 尽管NAVA增加了呼吸周期的变化,但在通风分布或减少静音空间方面没有系统的改善.
- 这些发现表明,虽然NAVA增强了呼吸模式的可变性,但其对整体通风分布的影响需要进一步研究.
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