急诊ICU机械通气患者人机对抗原因分析及处理

Discussion on the Reasons and Strategy of Patients with Mechanical Ventilation Resisted to Respiratory Ventilator in Emergency ICU

目的分析急诊 ICU 机械通气患者人机对抗的原因并探讨其处理策略,指导临床治疗。方法对2003年6月～2005年12月间急诊 ICU 85例气管插管或气管切开机械通气患者人机对抗的原因及处理进行回顾性调查。结果因缺氧诱发自主呼吸过快导致人机对抗最多见,占44.50%。不能耐受气管插管,气管导管过深或脱出,气囊破裂,管道漏气以及气管内分泌过多,参数设计不当等为机械通气时人机对抗的常见原因。结论发生人机对抗应尽快查找原因,及时处理,才能保证有效的通气,减少并发症的出现。

Objective To discuss on the reason and strategy of patients with mechanical ventilation resisted to respiratory ventilator in emergency ICU and guide clinic treatment. Methods To analyze the reason and strategy of 85 patients with mechanical ventilation resisted to respiratory ventilator retrospectively in emergency ICU from June 2003 to December 2005. Results The most common reasons of resisted to respiratory was rapid spontaneous breathing frequency with oxygen deficiency. There were 37 cases （44. 5% ） among 85 cases. There were many other common reasons such as intolerance tracheal intubation, trachecl intubation too deep, pipe line air leakage, no exactitude parameter installation etc. Conclusion We should pay attention to the reason of the resistance of respiratory ventilator early as possible and solve fastly for the effective ventilation and decreasing complication.