基于肺的静态压强—容积曲线估计肺复张特性的研究

Estimation of lung recruitment characteristics using the static pressure-volume curve of lungs

机械通气是急性呼吸窘迫综合征患者在生命支持期间重要的呼吸支持技术。机械通气的临床效果与患者的肺复张特性密切相关。确定患者肺复张特性对选择恰当的通气策略并设置相关参数具有重要意义。目前,尚缺少可便捷估计肺复张特性的床旁方法。本文提出了一种基于肺的静态压强—容积曲线估计肺复张特性的方法,并采用公开的动物实验数据对该方法进行了验证。结果显示,应用该方法得到的肺复张结果与文献数据高度相似,提示该方法可用于估计肺复张特性。考虑到一些先进的呼吸机具备自动测量静态压强—容积曲线的功能,可认为本文方法具备床旁应用潜力,能够辅助医生依据患者的肺复张特性选择与之匹配的通气策略,为个性化设置呼吸机参数提供参考。

Mechanical ventilation is an importmant life-sustaining treatment for patients with acute respiratory distress syndrome.Its clinical outcomes depend on patients’characteristics of lung recruitment.Estimation of lung recruitment characteristics is valuable for the determination of ventilatory maneurvers and ventilator parameters.There is no easily-used,bedside method to assess lung recruitment characteristics.The present paper proposed a method to estimate lung recruitment characteristics from the static pressure-volume curve of lungs.The method was evaluated by comparing with published experimental data.Results of lung recruitment derived from the presented method were in high agreement with the published data,suggesting that the proposed method is capable to estimate lung recruitment characteristics.Since some advanced ventilators are capable to measure the static pressure-volume curve automatedly,the presented method is potential to be used at bedside,and it is helpful for clinicians to individualize ventilatory manuevers and the correpsonding ventilator parameters.