床旁超声对机械通气拔管的预测价值

The value of bedside ultrasound on weaning from ventilator

有创机械通气时,监测患者的呼吸力学指标、自主呼吸试验和临床表现有助于判断脱机拔管。然而不同指标之间预测脱机拔管有所差异,寻找预测脱机拔管成功率更高的指标成为临床医师的目标。床旁超声作为一种影像学检查,具有快速无创、无辐射、可重复操作、连续性检测等优点,已广泛被用于临床危重患者的救治。通过膈肌超声和肝脾移动度预测脱机拔管的研究显示了良好的临床可行性和成功率。现将床旁超声在有创机械通气脱机拔管中的应用作以简单叙述。

In the area of invasive ventilation, monitoring the patient′s respiratory mechanics, spontaneous breathing tests, clinical signs and symptoms can help the physicians to determine if extubation is conducted. However, different predictors are discrepant. Thus it is important for clinicians to seek the more safe and successful predictors. Bedside ultrasound as a diagnostic method has some merits, such as rapid, noninvasive, less radiation, reproducible operation and continuous monitor. It has been widely used in critical patients. The observation of diaphragm and liver or spleen mobility by ultrasound may predict the weaning from ventilation. Many studies has showed beside ultrasound is feasible and successful. Now we described briefly the application of bedside ultrasound on weaning.