机械通气中患者人机不同步研究进展

Progress in Research of Patient-Ventilator Asynchrony During Mechanical Ventilation

呼吸机机械通气作为维持患者生命的重要医疗手段,主要作用为改善患者气体交换、降低呼吸肌负荷及提高患者舒适度。患者在机械通气期间需要与呼吸机统一协调,二者交互达到最佳状态时才能保证其治疗效果。文章简要介绍人机不同步的研究进展,并总结临床上常见的人机不同步类型,不同类型事件对应的影响因素以及处理方法。根据人机不同步的临床识别提出一种集成于呼吸机监测和识别的功能理念,将人机不同步在呼吸机机械通气的过程中直观地展现并且量化,为临床医生提供参考,以减少人机不同步事件的发生。

As an important medical means to maintain the patient's life,mechanical ventilation by ventilator is mainly used to improve the patient's gas exchange,reduce the respiratory muscle load,and improve the patient's comfort.The patient needs to coordinate with the ventilator during mechanical ventilation,and the treatment effect can be guaranteed only when the interaction between the two is optimal.This article briefly introduces the development of patientventilator asynchrony,and summarizes the common types of patient-ventilator asynchrony,the influencing factors corresponding to different types of events,and the handling methods.According to the clinical identification of patient-ventilator asynchrony,a functional concept integrated in ventilator monitoring and identification is proposed.The patient-ventilator asynchrony is visually displayed and quantified during the mechanical ventilation of the ventilator for providing reference for clinicians to reduce the occurrence of patient-ventilator asynchrony.