适应性支持通气模式在长期机械通气非COPD患者中的临床应用
Clinical application of adaptive support ventilation on non-COPD patients of long-term ventilation
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摘要: 目的: 探讨适应性支持通气(adaptive support ventilation,ASV)模式在长期机械通气非慢性阻塞性肺疾病(chron ic obstructive pu lmonary d isease,COPD)患者中的临床应用。方法: 2004年1月至2005年3月,选择我院老年病房长期机械通气的非COPD患者13例。应用ASV模式后,再转换为PS-SIMV模式,使应用两种呼吸模式时每分通气量(MV)相同。应用每种呼吸模式,均待患者呼吸平稳30 m in后,记录患者的呼吸力学指标:潮气量(Vt)、呼吸频率(f)、气道峰压(P peak)、平均气道压(P m ean)、吸气流速(Insp flow)、呼气流速(Exp flow)、吸气阻力(R insp)、呼气阻力(Rexp)、吸气时间常数(RC inp)、呼气时间常数(RCexp)等,同时测心率、血压,并抽取动脉血进行血气分析。结果: 13例非COPD患者应用ASV模式,与PS-SIMV模式比较,呼吸力学、血流动力学及动脉血气分析均无统计学差异(P>0.05),但应用ASV时,患者舒适程度更好。结论: ASV模式要求设置参数...Abstract: Objective: To study the clinical application of adaptive support ventilation on non-COPD patients of long-term ventilation. Methods: 13 elderly non-COPD patients of long-term ventilation were selected in elderly wards in our hospital from Jan 2004 to Mar 2005. Two modes in which minute volume was consistent were applied: ASV and PS-SIMV. The variables of respiratory mechanics were recorded,meanwhile,the variables of hemodynamics and arterial blood analysis were measured after 30min in all modes. Results: Compared with PS-SIMV,the variables of respiratory mechanics,hemodynamics and arterial blood analysis had no change in ASV.In the two groups,the 13 patients applied with ASV felt more comfortable. Conclusions: ASV can be applied with less parameters,easier manipulation,less respiratory effort and better patient-ventilator interaction.
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