在心脏手术后的儿科患者中PEEP对肺气化的影响:基于CT的研究
Solange C Gimenez1, Milene C Carrilho1, Isabela M Malbouisson1
1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Divisão de Anestesia, São Paulo, SP, Brazil.
Brazilian journal of anesthesiology (Elsevier)
|April 24, 2025
概括
儿童心脏手术可能导致肺空气损失. 阳性末尾呼吸压力 (PEEP) 改善了肺气体体积,但在心脏缺陷修复后的儿童中没有完全重新膨胀塌的肺部区域.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心胸外科手术 心胸外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 儿童心脏手术后的肺气化变化尚未得到充分了解.
- 成年人经常经历心肺旁路术后的肺气化损失.
- 阳性终端呼气压 (PEEP) 对儿科肺气化后先天性心脏缺陷修复的影响尚不清楚.
研究的目的:
- 为了研究患有先天性心脏缺陷修复的儿童的肺气化变化.
- 为了评估正极呼气压 (PEEP) 对手术后肺空气的作用.
主要方法:
- 容量计计算断层扫描 (CT) 用于12名患有先天性病原性心脏病的儿童.
- 在机械通风期间在手术前和手术后获得的CT扫描,具有不同PEEP水平 (0,5,10厘米H2O).
- 气体,组织,非空气,空气不足和空气正常的肺区的量化.
主要成果:
- 在手术后,在零PEEP时,非气化肺区显著增加.
- 循序渐进的PEEP应用 (高达10厘米的H2O) 将正常通风的肺体积恢复到手术前的水平.
- PEEP并没有显著减少非空气性肺上空膜.
结论:
- 手术纠正先天性心脏缺陷导致肺空气的显著损失.
- 阳性末尾呼气压 (PEEP) 有效地恢复了肺气体体积,但未能完全招募崩的肺组织.
- 可能需要进一步的策略来解决在儿科心脏手术后持续的肺脱氧症.
相关概念视频
Factors Affecting Pulmonary Ventilation
1.0K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.0K
Pulmonary Cycle: Exhalation
1.3K
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.3K
Assessment of Ventilation I: Respiratory Rate
978
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
978
Ventilatory Modes
45
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
45
Pneumothorax-II
111
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
111
Pneumonia V: Nursing management and Prevention
1.8K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.8K


