呼吸驱动和吸气努力的监测与评价

Dynamic monitoring of respiratory drive and inspiratory effort

肺-膈肌保护性通气旨在限制危重症患者在机械通气过程中肺和膈肌的副损伤。其中呼吸驱动和吸气努力的动态监测是临床实施肺-膈肌保护性通气的重点。本文按照呼吸驱动的生理路径,自上而下的在呼吸肌、压力变化和肺通气三个层面对现有的呼吸驱动和吸气努力的监测指标进行综述,分别对其意义、获得方式、相应界值以及优缺点逐一进行讨论。

Lung-diaphragmatic protective ventilation aims to limit damage to the lung and diaphragm during mechanical ventilation in critically ill patients.The dynamic monitoring of respiratory drive and inspiratory effort is the focus of the clinical strategies for implementating lung-diaphragm protective ventilation strategies.This paper reviews the existing indicators for dynamic monitoring of respiratory drive and inspiratory effort at the three levels of respiratory muscle,pressure change,and pulmonary ventilation according to the physiological pathway of respiratory drive and discusses their significance,acquisition methods,and thresholds.