机械通风中的机械功率及其与通风器引起的肺损伤的关系:系统性审查
Tomasz Urbankowski1, Raman Pasledni1, Marek Darowski1
1Department of Modeling and Supporting of Internal Organs Functions, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, ul. Ks. Trojdena 4, 02-109, Warsaw, Poland.
Respiratory medicine
|November 21, 2025
概括
机械功率 (MP) 是机械通风成年人的不良结果的可靠预测指标. 较高的MP与死亡率增加和呼吸时间延长有关,为肺部保护策略确定了值.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统生理学 呼吸系统生理学
- 临床结果研究研究
背景情况:
- 机械功率 (MP) 集成了通风器设置,以量化输送到呼吸系统的能量.
- MP是呼吸器诱导肺损伤 (VILI) 的建议标志物,但其临床一致性仍在争论中.
研究的目的:
- 系统地评估MP和VILI相关结果在侵袭性机械通风的成年患者之间的关联.
- 提供MP的预后价值的全面评估.
主要方法:
- 在四个主要数据库中按照PRISMA指南进行系统审查.
- 使用RoB 2.0,ROBINS-I和GRADE评估的偏差风险和证据确定性.
- 分析了46项涉及314,823名成年患者的研究.
主要成果:
- 在87%的研究中发现了较高的MP和不良结果 (死亡率,长时间通风,ICU停留) 之间的显著关联.
- 确定了MP的值效应,通常在14-18 J/min之间.
- 正常化的MP显示出更好的预后性能,这表明在多样化的患者队列中有用.
结论:
- 机械功率已被确立为机械通风成年人不良结果的一致和临床相关预测指标.
- 这种对超过30万名患者的综合分析为MP的作用提供了强有力的证据,并确定了关键值.
- MP可以补充现有的肺保护通风策略 (潮体积,驱动压力),指导未来的研究.
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