机械通风患者呼吸不良和呼吸驱动之间的关系:一项前性观察性研究
Chie Hatozaki1, Hideaki Sakuramoto2, Gen Aikawa3
1Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Japan.
概括
机械通风 (MV) 患者有高呼吸驱动可能会出现肺损伤. 这项研究在MV患者,特别是那些深度镇静的患者中,发现呼吸障碍尺度和呼吸驱动 (P0.1) 之间存在弱负相关性.
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
- 临床测量 临床测量
背景情况:
- 机械通风 (MV) 期间的高呼吸力驱动会造成呼吸器引起的肺损伤的风险.
- 在MV患者中,高呼吸驱动和呼吸障碍之间的关联还没有得到很好的定义.
研究的目的:
- 在接受MV的患者中,研究三种呼吸不良评分尺度和呼吸驱动 (P0.1) 之间的关系.
- 澄清主观呼吸障碍与呼吸努力的客观测量之间的关联.
主要方法:
- 在ICU (2020年2月 - 2022年3月) 进行前性观察研究,包括需要MV>24小时的成年人.
- 使用三种经过验证的尺度评估呼吸困难,并通过气道阻塞压力 (P0.1) 测量呼吸驱动.
- 利用皮尔森的相关系数来分析呼吸障碍得分与P0.1.1之间的关系.
主要成果:
- 在整体队列中,在所有三种呼吸障碍尺度和P0.1之间观察到弱负相关性 (r = -0.293到 -0.240).
- 分层分析显示,深度镇静组的弱负相关性更强 (r = -0.347至 -0.325).
- 当按疾病或严重程度分层时,没有发现显著的相关性.
结论:
- 在MV患者中,主观呼吸不良评分和客观呼吸驱动 (P0.1) 之间存在微弱的负相关性.
- 镇静水平可能会影响感知呼吸不良和呼吸驱动之间的关系.
- 需要进一步的研究才能充分理解这种复杂的关系.
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