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肺部手术期间保护性通风的变化和偏离.

Matthew C So1, Camila Machado de Souza2, Gordon Buduhan3

  • 1Department of Radiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

JTCVS techniques
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PubMed
概括

在单肺通风 (OLV) 期间的肺保护性通风对于减少术后肺部并发症 (PPC) 至关重要. 对保护策略的坚持很低,OLV期间更高的峰值启发压力与增加的PPC有关.

关键词:
酒吧创伤是什么意思一个肺的通风通风.积极压力呼吸呼吸系统肺部外科手术手术是指肺部外科手术.潮的体积是潮的体积.

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科学领域:

  • 麻醉学 麻醉学
  • 胸部外科手术 胸部外科手术
  • 关键护理医学 关键护理医学

背景情况:

  • 一肺通风 (OLV) 是肺切除的标准,需要保护性通风以尽量减少肺损伤.
  • 手术后的肺部并发症 (PPC) 是肺部手术后的一个重大问题.
  • 了解OLV期间的呼吸系统策略是改善患者治疗结果的关键.

研究的目的:

  • 描述OLV期间当前的通风策略.
  • 确定影响这些策略的因素.
  • 调查OLV通风和PPC之间的关联.

主要方法:

  • 对225名接受肺部手术的患者进行前性队列研究.
  • 实时的手术内通风数据收集.
  • 使用太华胸部发病率和死亡率分类对PPC的评估.
  • 统计分析包括多变量回归.

主要成果:

  • 平均潮体积为6.4毫升/公斤,只有7.5%的手术达到<5毫升/公斤VT的目标.
  • 观察到PEEP≥5cmH2O的高度坚持 (86.7%).
  • 峰值吸气压的增加和较长的OLV持续时间与PPC有显著的关联.

结论:

  • 在OLV期间,对肺部保护性通风的坚持仍然低于最佳.
  • 在OLV期间峰值吸气压升高是PPC的重要风险因素.
  • 准降低峰值呼吸压力是提高质量和知识转化的一个关键领域.