摘要
目的:探讨动态监测气道闭合压(P0.1)在预测成功脱机中的应用意义。方法:各种呼吸衰竭需要机械通气患者在应用压力支持通气(PSV)脱机时,每8小时测定1次P0.1,同时记录患者的潮气量(VT)、通气量(VE)、呼吸频率(RR)、潮气末二氧化碳分压(ETCO2)、经皮血氧饱和度(SpO2),以及压力支持(PS)水平,将患者分为脱机成功组(24例)和脱机失败组(16例)进行对照分析。结果:在PSV期间,脱机成功组P0.1、VE均无明显变化(P>0.05);脱机失败组P0.1结束前值(0.75±0.36kPa,1kPa=10.20cmH2O)与基础值(0.41±0.28kPa)以及与脱机成功组同期值(0.27±0.09kPa,0.28±0.15kPa)比较均明显升高(P均<0.01),VE较脱机成功组明显升高(P<0.05)。P0.1与VE明显相关(r=0.62,P<0.05)。结论:动态观察P0.1,对于常规参数处于边缘值欲脱机患者将可明显提高脱机成功率。
Objective:To evaluate application of a serial measurement of airway occlusion pressure (P 0.1 ) combined with traditional weaning parameters in prediction weaning from mechanical ventilation.Methods:During weaning from pressure support ventilation (PSV),P 0.1 was measured per eight hours in patients with respiratory failure needing mechanical ventilation.V T,V E,RR,E TCO 2,SpO 2 and pressure support (PS) levels were recorded simultaneously in these patients.Patients were divided into two groups: successful weaning group (24 cases) and failure weaning group (16 cases).Results:During PSV,P o.1 ,V E in successful group were not markedly changed ( P >0.05).In failure group,P o.1 of perend value (0.75±0.36kPa,1kPa=10.20cm H 2O) was significantly higher than that of basal value (0.41±0.28 kPa),and also those of successful group (0.27±0.09 kPa,0 28±0 15kPa, all P <0.01).Similarly,V E in failure group was significantly higher than that in successful group ( P <0.05).A significant correlation was found between P 0.1 and V E ( r =0.62, P <0.05).Conclusions:P o.1 has been shown to be a predictor for the ability of ventilated reserve.Decision of weaning from marginal value of conventional parameters combined with a serial measurement of P 0.1 would significantly increase successful rate of weaning from mechanical ventilation in patients.
出处
《中国危重病急救医学》
CAS
CSCD
1997年第4期221-223,共3页
Chinese Critical Care Medicine
基金
天津市卫生局科研课题
关键词
气道闭合压
机械通气
压力支持通气
动态监测
airway occlusion pressure
mechanical ventilation
pressure support ventilation