评估一种用于清理下方航空公司分泌物的新设备
Luigi Vivona1,2, Fabiana Madotto1, Eleonora Carlesso3
1Drs. Vivona, Madotto, Florio, Sodi, Panigada, Prof. Zanella, and Grasselli are affiliated with Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Respiratory care
|April 28, 2025
概括
一种新设备使用呼吸机同步来制造人工咳,有效清除近80%的入侵通风患者的呼吸道分泌物. 这种方法可以准确估计咳流量,并有望改善呼吸系统护理.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 生物医学工程 生物医学工程
- 临界护理医学 临界护理医学
背景情况:
- 内管道输管可以导致呼吸道分泌物保留,增加感染和阻塞的风险.
- 一种新的内肌袖子控制器与呼吸机同步,产生"人工咳"以去除分泌物.
- 该装置旨在在侵入性通风过程中清除内管袖口上方和下方的分泌物.
研究的目的:
- 为了验证用于估计人工咳流量的体外计算.
- 为了评估设备在将分泌物向口腔移动方面的有效性,在被直管的受试者中.
- 评估人工咳操作的安全性和有效性.
主要方法:
- 在体外:比较计算的咳流量 (呼气体积损失/膨胀持续时间) 与用米计测量的实际流量.
- 临床:招募了28名接受侵入性通风治疗的重症监护室 (ICU) 患者.
- 在呼吸机吸气过程中通过短暂的内管袖口膨胀进行了三次人工咳;在呼吸机吸气之前和之后收集口服吸气剂.
主要成果:
- 在实验室内,实际和计算的咳流量之间存在强烈的线性关联 (r=0.991).
- 在78.6%的受试者 (响应者) 中,在操纵后检测到口腔分泌物.
- 产生了有效的咳流量 (平均最高23.3L/分钟);除了一次过渡性低血压外,没有发现显著的不良事件.
结论:
- 咳流量可以准确地估计,使用在袖口通气过程中失去的呼气体积.
- 在大多数患者中,人工咳装置有效清除了从气管到口腔的分泌物.
- 这项技术为入侵通风患者的呼吸道分泌物管理提供了一种有前途的方法.
相关概念视频
Suctioning the Nasopharyngeal Airway
198
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
198
Suctioning the Oropharyngeal Airway
132
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
132
Inhaled Medications
196
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
196
Asthma-IV: Diagnostic and Management
2.5K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.5K
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
156
Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
156
Acute Respiratory Failure-V
102
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
102


