智能全闭环控制通气模式在心脏术后患者应用的有效性

Efficacy of full closed-loop control ventilation in post-cardiac surgery patients

目的探讨智能全闭环控制通气模式在心脏术后患者中应用的有效性。方法选取2014年4～10月非急诊心脏手术术后需要机械通气的患者，分别接受Intellivent-ASV和ASV通气模式。记录两组入ICU时（TO）、1h末（T1）、2h末（T2）、SBT前（T3）的呼吸机设置参数，呼吸机监测（潮气量、肺顺应性、通气支持程度等）等指标；观察比较两组TO，T1，T2，T3、停用呼吸机后1K（T4）的血气分析、血流动力学等指标进行统计。结果本研究共纳入患者82例，Intellivent-ASV组患者43例（52．4％），ASV组患者39例（47．6％）。①呼吸机参数设置：两组在吸氧浓度（Fi02）、呼气末正压（PEEP）、MinVol后期设置上差异有统计学意义（P〈0．05），且在Intellivent-AsV组内差异均有统计学意义（P〈0．05）。②血气分析指标：两组T1点PaCO。差异有统计学意义。Intellivent-ASV组组内PaO2／Fi02差异有统计学意义。③Intellivent-AsV组内PetCO2与PaCO2之间呈正相关（R2=0．607，P〈0．05）。结论Intellivent-ASV通气模式在成人择期心脏术后患者中使用具有安全性。应用PetCO2可以连续、及时的监测呼吸指标变化，为患者提供有效的通气支持。

Objective To estimate the efficacy of IntelliVent-ASV mode in post-cardiac surgery patients. Methods This study included patients with postcardiac surgery who were invasively ventilated in ICU from April to October in 2014. Two group patients were ventilated using IntelliVent-ASV mode and ASV mode respectivelyfrom inclusion to extubation. Ventilation machine setting parameters, Tidal volume, static lung compliance inspiratory pressure were monitored and recorded in TO, T1, T2, T3. Monitoring of vital signs haemodynamics, blood gas analysis（ABG） in TO, T1, T2, T3, T4. Results This study participants included 82 patients were randomized in Intellivent-ASV group （ n = 43,52.40%） and ASV group （n = 39, 47.6%）. ①Ventilation machine setting parameters： fraction of inhaled oxygen （FiO2）, postive end-expiratory pressure （PEEP）, MinVolwassignificantly different between Intellivent- ASV groupand ASV group respectively, especially in Intellivent-ASV group. （2）ABG： Inlntellivent-ASV group, PaCO2 was significantly different in T1, PaO2/FiO2 also was statistically different in Intellivent- ASV group. （3）the linear regression shows the positive correlation between PetCOz ancl PaCOz （R2 = 0. 607, P 〈0.05） in Intellivent-ASV group. Conclusions IntelliVent-ASV can continuously and timely auto adjust paihmeters to improves an effective support forposteardiae surgery patients.