血液动力学变化和呼吸机断奶结果的比较评估
Dina Zeid Roushdy1, Hossam Ahmed Saad1, Randa Aly Soliman1
1Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egipt.
概括
与压力支 (PS) 相比,可变压力支 (VPS) 提供了比机械通风更舒适和生理上的断奶. 心声学证实了血液动力学差异,但患者的结果,如呼吸机日和存活率在模式之间是相似的.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 机械通风对于重症患者至关重要.
- 呼吸机模式可以影响患者的血液动力学和结果.
- 过渡到自发呼吸模式是断奶的一个关键步骤.
研究的目的:
- 在从体积控制通风 (VCV) 过渡到可变压力支 (VPS) 的过程中评估血液动力学变化,而不是使用心声学将VCV转变为压力支 (PS).
- 为了比较VPS和PS在断奶机械通风中的有效性.
- 评估结果,包括呼吸机日,住院时间和生存时间.
主要方法:
- 对40名机械通风患者进行前性观察性研究,准备切断哺乳.
- 在VCV到VPS (A臂) 和VCV到PS (B臂) 过渡期间进行心声学评估 (食管和胸管).
- 两个手臂之间的断奶成功,呼吸机日,医院日和生存率的比较.
主要成果:
- 在VPS和PS组之间观察到血液动力学参数的显著差异,例如速度时间积分 (VTI),中风体积 (SV) 和心脏输出 (CO) (p<0.05).
- 没有发现呼吸器日 (p=0.88),停留时间 (p=0.651),断奶成功 (p=0.525) 或生存率 (p=0.525) 的显著差异.
结论:
- 可变压力支 (VPS) 是压力支 (PS) 的一个有前途的替代方案,用于断奶,提供更好的患者舒适性和生理呼吸传递.
- 在这种情况下,可以互换使用跨胸腔心声学 (TTE) 和跨食道心声学 (TEE) 来评估血液动力学变化.
- 虽然血液动力学概况不同,但VPS和PS在机械通风中断奶的临床结果相似.
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