神經(jīng)調(diào)節(jié)輔助通氣在重癥創(chuàng)傷性濕肺合并ARDS患者中的應(yīng)用
發(fā)布時間：2019-06-07 10:58
【摘要】：目的:探索在重癥創(chuàng)傷性濕肺(STWL)患者中應(yīng)用神經(jīng)電活動輔助通氣(NAVA)模式與傳統(tǒng)壓力支持通氣(如PSV)模式相比較時,其人機同步性、呼吸力學(xué)、氣體交換能力、血流動力學(xué)上的差異。方法:以18例需機械通氣的重癥創(chuàng)傷性濕肺患者為研究對象,每例患者隨機先任選NAVA或PSV模式進(jìn)行機械通氣120min,再換用另一種通氣模式。比較同一患者在兩種通氣模式下,其人機同步性、呼吸力學(xué)、氣體交換能力、血流動力學(xué)等方面的不同。結(jié)果:18例患者的血流動力學(xué)(HR、CVP)及氣體交換能力(動脈血pH值、PaO2、PaCO2、SaO2)在兩種模式間無明顯差異(P0.05),在人機同步性(Trigger delay、Off cycle delay)及呼吸力學(xué)(PIP、Pmean)方面NAVA優(yōu)于PSV,差異具有顯著性(P0.05)。結(jié)論:對于重癥創(chuàng)傷性濕肺機械通氣患者,NAVA模式比PSV模式,具有人機協(xié)調(diào)性高、呼吸力學(xué)穩(wěn)定等優(yōu)勢,而在血流動力學(xué)及氣體交換能力上具有相似的安全性。
[Abstract]:Objective: to explore the man-machine synchronization, respiratory mechanics and gas exchange ability of neuroelectrical activity-assisted ventilation (NAVA) model compared with traditional pressure-supported ventilation (such as PSV) mode in patients with severe traumatic wet lung (STWL). Hemodynamic differences. Methods: 18 patients with severe traumatic wet lung who needed mechanical ventilation were randomly selected for mechanical ventilation in NAVA or PSV mode for 120 min, and then another ventilation mode. The differences of man-machine synchronization, respiratory mechanics, gas exchange capacity and hemodynamics in the same patient under the two ventilation modes were compared. Results: there was no significant difference in hemodynamics (HR,CVP) and gas exchange capacity (PaO2,PaCO2,SaO2) between the two models (P 0.05), but there was no significant difference in man-machine synchronization (Trigger delay,Off cycle delay) and respiratory mechanics (PIP,). There was significant difference between NAVA and PSV, in Pmean (P 0.05). Conclusion: for patients with severe traumatic wet lung mechanical ventilation, NAVA mode has the advantages of higher human-computer coordination and stable respiratory mechanics than PSV mode, and has similar safety in hemodynamics and gas exchange ability.
【作者單位】： 天津醫(yī)科大學(xué)一中心臨床學(xué)院ICU;
【基金】：天津市衛(wèi)生局科技基金(2010KY07)
【分類號】：R655;R563.8
本文編號：2494743
[Abstract]:Objective: to explore the man-machine synchronization, respiratory mechanics and gas exchange ability of neuroelectrical activity-assisted ventilation (NAVA) model compared with traditional pressure-supported ventilation (such as PSV) mode in patients with severe traumatic wet lung (STWL). Hemodynamic differences. Methods: 18 patients with severe traumatic wet lung who needed mechanical ventilation were randomly selected for mechanical ventilation in NAVA or PSV mode for 120 min, and then another ventilation mode. The differences of man-machine synchronization, respiratory mechanics, gas exchange capacity and hemodynamics in the same patient under the two ventilation modes were compared. Results: there was no significant difference in hemodynamics (HR,CVP) and gas exchange capacity (PaO2,PaCO2,SaO2) between the two models (P 0.05), but there was no significant difference in man-machine synchronization (Trigger delay,Off cycle delay) and respiratory mechanics (PIP,). There was significant difference between NAVA and PSV, in Pmean (P 0.05). Conclusion: for patients with severe traumatic wet lung mechanical ventilation, NAVA mode has the advantages of higher human-computer coordination and stable respiratory mechanics than PSV mode, and has similar safety in hemodynamics and gas exchange ability.
【作者單位】： 天津醫(yī)科大學(xué)一中心臨床學(xué)院ICU;
【基金】：天津市衛(wèi)生局科技基金(2010KY07)
【分類號】：R655;R563.8
【共引文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 楊銀芬;通腑瀉熱法輔助治療外科膿毒癥急性肺損傷的臨床研究[D];廣州中醫(yī)藥大學(xué);2008年
【二級參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 趙富麗;;適應(yīng)性支持通氣在急性呼吸衰竭治療中的應(yīng)用[J];江蘇醫(yī)藥;2006年10期
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 張曉飛;劉艷梅;;老年性慢性支氣管炎肺氣腫合并多發(fā)肋骨骨折67例治療體會[J];基層醫(yī)學(xué)論壇;2011年19期
2 ;[J];;年期
3 ;[J];;年期
4 ;[J];;年期
5 ;[J];;年期
6 ;[J];;年期
7 ;[J];;年期
8 ;[J];;年期
9 ;[J];;年期
10 ;[J];;年期
相關(guān)碩士學(xué)位論文 前1條
1 林竹;神經(jīng)調(diào)節(jié)輔助通氣在重癥創(chuàng)傷性濕肺合并ARDS患者中的應(yīng)用[D];天津醫(yī)科大學(xué);2012年
，本文編號：2494743
本文鏈接：http://sikaile.net/yixuelunwen/huxijib/2494743.html
最近更新
教材專著
