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Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pregnant Patient: A Case Series
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作者 Carlos Montufar-Rueda Agnès Ditisheim +5 位作者 Alfredo F. Gei Rolando Pinilla Eddie Dinh Jair Vélez Brenda Castillo Luis Farias 《Open Journal of Obstetrics and Gynecology》 2020年第11期1563-1572,共10页
<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failur... <strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span> 展开更多
关键词 Respiratory Support during Pregnancy ARDS in Pregnancy ALI in Pregnancy ventilatory Support non-Invasive Positive Pressure ventilation
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Cardiopulmonary Stability on a Patient with Hip Fracture and Severe Pulmonary Hypertension, Anesthetized with Lumbar-Sacral Plexus Block and Non-Invasive Ventilation: Case Report
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作者 Uribe Campo Giselle Andrea Perales Caldera Eduardo +3 位作者 Prol Carreiro Adolfo Velazco González Jose Gamaliel Díaz Borjón Efraín Morales Maldonado Rubén Alejandro 《Open Journal of Anesthesiology》 2022年第10期301-314,共14页
Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension unde... Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension undergoing surgical procedures such as hemiarthroplasty present a high risk of fatal complications. Nonetheless, there are no widely accepted protocols explaining their perioperative care in great detail. Case presentation: We present a case with an 89-years-old patient, with comorbidities such as GOLD 4D chronic obstructive pulmonary disease (COPD) and, as a consequence of this, severe pulmonary hypertension with signs of right ventricular dysfunction, thus requiring of pulmonary vasodilator, that has suffered a subcapital hip fracture requiring urgent surgery. Surgery is carried out successfully, under regional lumbar-sacral plexus block and sedation assisted by non-invasive ventilation. Conclusion: Multidisciplinary specialized treatment, preoperative optimization, as well as the careful selection of both the surgical and anesthetic techniques to be used, are among the strategies that improve the perioperative outcome in patients with pulmonary hypertension with right ventricle systolic dysfunction. Regional lumbar-sacral plexus block plus sedation is a technique that maintains hemodynamic stability;however, these patients require advance measures and postoperative monitoring under intensive care. 展开更多
关键词 Hip Fracture Pulmonary Hypertension Lumbar-Sacral Plexus Block non-Invasive ventilation Right Ventricular Failure
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Effect of metronome rates on the quality of bag-mask ventilation during metronome-guided 30:2 cardiopulmonary resuscitation:A randomized simulation study 被引量:12
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作者 Ji Ung Na Sang Kuk Han +1 位作者 Pil Cho Choi Dong Hyuk Shin 《World Journal of Emergency Medicine》 CAS 2017年第2期136-140,共5页
BACKGROUND: Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation(CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and t... BACKGROUND: Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation(CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates(100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR.METHODS: This is a prospective, randomized, crossover observational study using a Respi Trainer r. To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate(1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive(total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks(1.0 to 1.2 seconds depending on the rate of metronome) and defl ate the bag over 2 ticks. The sequence of three different metronome rates was randomized.RESULTS: Mean tidal volume significantly decreased as the metronome rate was increased from 110 ticks/minute to 120 ticks/minute(343±84 m L vs. 294±90 m L, P=0.004). Peak airway pressure significantly increased as metronome rate increased from 100 ticks/minute to 110 ticks/minute(18.7 vs. 21.6 mm Hg, P=0.006).CONCLUSION: In metronome-guided 30:2 CPR, a higher metronome rate may adversely affect the quality of bag-mask ventilations. In cases of cardiac arrest where adequate ventilation support is necessary, 100 ticks/minute may be better than 110 or 120 ticks/minute to deliver adequate tidal volume during audio tone guided 30:2 CPR. 展开更多
关键词 non-invasive ventilation RESUSCITATION Cardiac arrest Cardiopulmonary resuscitation
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Effect of Oxygen Therapy by Venturi Mask versus Non Invasive Ventillation on the Outcome of Patients Who Devolope Hypoxia after Open Heart Surgery
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作者 Yousry El-Saied Rizk Tarek Samy Essawy +2 位作者 Ahmed Hamdy Abd Elrahman Ali Mohamed Ahmed El-Gazzar Abdelkhalek Fouad Mahmoud 《Open Journal of Anesthesiology》 2018年第9期241-254,共14页
Background: Cardiothoracic surgery is a common cause of acute respiratory failure and is associated with increased morbidity and mortality. We aimed to compare the outcomes of open heart surgery patients treated using... Background: Cardiothoracic surgery is a common cause of acute respiratory failure and is associated with increased morbidity and mortality. We aimed to compare the outcomes of open heart surgery patients treated using oxygen delivery devices with patients who receive NIV as a first-line therapy for hypoxemic respiratory failure. Materials and Methods: 40 patients who developed acute hypoxemic respiratory failure after open heart surgery and admitted to cardiothoracic ICU 20 patients received NIV and 20 patient received oxygen by venture mask. For all patients the following measurements were performed before and after CPAP AND Venture use: CBC, blood urea, serum creatinine body temperature, chest X-ray, Arterial blood gases (arterial pH, sodium bicarbonate, pcO2, SpO2 and PaO2-to-FiO2 ratio). Results: Mean PO2 and SO2 have increased after using of both venture and Cpap, increase in both PCO2 and HCO3 levels after using Venturi mask, CPAP mask was superior to venturi mask in avoiding the need of intubation, decreasing The ICU stay median length and also median length of hospitalization, all were lower in CPAP group than venture group. Also the mortality rate was lower in CPAP group than the venturi group. Conclusion: Using CPAP mask in severe AHRF following open heart surgery can avoid intubation, decreases the levels of tachypnea and arterial hypoxemia, decreases ICU stay, the length of hospitalization and also decreases the mortality rate compared with patients receiving high-concentration oxygen therapy with venture mask. 展开更多
关键词 Open Heart Surgery VENTURE MASK CPAP MASK non INVASIVE ventilation O2 Therapy
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Respiratory Volume Monitoring to Assess the Effect of Airway Maneuvers on Ventilation during Upper Endoscopy 被引量:1
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作者 Katherine Holley Donald Mathews +2 位作者 Diane Ladd Lisa Campana Howard Schapiro 《Open Journal of Anesthesiology》 2014年第11期281-290,共10页
Introduction: Propofol use during endoscopic procedures has become increasingly popular and assessing and maintaining airway patency is a significant challenge. Anesthesiologists often use airway maneuvers to maintain... Introduction: Propofol use during endoscopic procedures has become increasingly popular and assessing and maintaining airway patency is a significant challenge. Anesthesiologists often use airway maneuvers to maintain airway patency and ventilation during procedural sedation. A novel, non-invasive, Respiratory Volume Monitor (RVM) that provided continuous, real-time measurements of minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) was used to monitor respiratory performance before, during, and after endoscopic procedures, quantify MV changes before and after airway maneuvers, and to quantify propofol-induced respiratory depression. Methods: RVM traces were obtained from 25 patients undergoing sedation for endoscopic procedures. Airway maneuvers were performed in 19/25 patients. All 25 patients received propofol as the primary sedative. Results: Forty-five airway maneuvers were performed. During these maneuvers, all respiratory parameters increased relative to pre-maneuver levels. On average, MV increased by 24% ± 5% (mean ± SEM), TV 14% ± 5% and RR: 17% ± 6%. The cohort average MVBASELINE was 9.5 ± 0.7 L/min (TV = 670 ± 60 ml, RR = 15 ± 0.7). Following propofol MV decreased transiently, reaching nadir five minutes after the last dose of propofol at 82% ± 10% of baseline (MV = 7.5 ± 1.0 L/min). The reduction in MV was driven by reduction in TV, not RR. Conclusions: Data demonstrated that RVM was able to track changes in ventilation and was able to quantify respiratory changes following airway maneuvers. All patients had a significant reduction in ventilatory volumes after propofol. Five minutes after the last dose of propofol, MV and TV were significantly reduced while RR was not, suggesting that monitoring respiratory rate alone was not a sufficient indicator of respiratory status. 展开更多
关键词 non-Invasive RESPIRATORY VOLUME MONITORING Minute ventilation Airway MANEUVERS PROCEDURAL SEDATION Endoscopy
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Clinical Study of P_(ET)CO_2 in One-lung Ventilation
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作者 张传汉 马自成 金士翱 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 1996年第3期179-182,共4页
Fourty-eight patients (ASA physical status Ⅰ - Ⅱ) undergoing selected thoracotomy and pulmonectomy were studied. They were divided into two groups according to different respiratory modes, two-lung ventilation (TLV)... Fourty-eight patients (ASA physical status Ⅰ - Ⅱ) undergoing selected thoracotomy and pulmonectomy were studied. They were divided into two groups according to different respiratory modes, two-lung ventilation (TLV) and onelung ventilation (OLV) or TLV and OLV with a Bain cyclic system for CPAP on the side of operated lung. PETCO2 and PaCO2 were measured after 30 min TLV,30 min and 60 min OLV, and repeated TLV (R-TLV) 30 min after pulmonectomy, to evaluate the difference between PETCO2 and PaCO2 in OLV and to observethe effect of abating hypoxemia and discharge of CO2 in OLV with Bain system.Our results showed that the PaCO2 and PETCO2 in different test groups were normal though the measured values in OLV were slightly higher than that in TLV (P<0. 05) , and then they were recovered after R-TLV (P>0. 05). There was nosignificant difference between group 1. and 2. in OLV (P>0. 05). There was aclose correlation between PETCO2 and PaCO2 (P<0. 05). The differences of the calculated P(a-ET)CO2 and radio of PETCO2/PaCO2 in different ventilation modes were not significant. Hypoxemia in OLV was corrected by Bain system, but the discharge of CO2 was not affected. The results showed that measurement of PET CO2 as a non-invasive procedure can be commonly used to monitor OLV. 展开更多
关键词 CO_2 partial pressure one-lung ventilation non-invasive monitoring
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布地奈德雾化吸入配合无创机械通气治疗老年慢性阻塞性肺疾病并发呼吸衰竭的疗效研究 被引量:4
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作者 张净 谭春婷 +2 位作者 王珊 石赟 陈颖 《中国医刊》 CAS 2024年第1期41-45,共5页
目的 探究布地奈德雾化吸入配合无创机械通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的老年患者的临床效果。方法 选取2022年2月至2023年2月首都医科大学附属北京友谊医院收治的82例COPD并发呼吸衰竭的老年患者82例,采用随机数字表法... 目的 探究布地奈德雾化吸入配合无创机械通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的老年患者的临床效果。方法 选取2022年2月至2023年2月首都医科大学附属北京友谊医院收治的82例COPD并发呼吸衰竭的老年患者82例,采用随机数字表法分为对照组和观察组,每组41例。对照组接受无创机械通气治疗,观察组在对照组治疗的基础上给予布地奈德(2 mg/次,2次/d)雾化吸入治疗,两组患者均治疗1周。比较两组治疗前后的肺功能、血气指标、生命体征指标、临床症状评分及血清低氧诱导因子-1α、血清淀粉样蛋白A水平,并比较两组治疗后的临床疗效。结果 治疗1周后,两组患者的肺功能指标(用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积与用力肺活量的比值、呼气峰值流速占正常预计值的百分比和6分钟步行试验距离)、动脉血氧分压、血氧饱和度、pH均高于治疗前,且观察组均高于对照组,差异有统计学意义(P<0.05),而呼吸频率、心率、动脉血二氧化碳分压、血清低氧诱导因子-1α、血清淀粉样蛋白A水平和临床症状评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为85.37%,明显高于对照组的73.17%,但差异无统计学意义(P>0.05)。结论 布地奈德雾化吸入配合无创机械通气治疗可有效提高COPD并发呼吸衰竭老年患者的肺功能,改善动脉血气、生命体征和临床症状,减轻机体的氧化应激和炎症反应,值得临床使用。 展开更多
关键词 布地奈德 无创机械通气 慢性阻塞性肺疾病 低氧诱导因子-1Α 血清淀粉样蛋白A
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The Value of Positive Pressure Ventilations for Clients in Acute Respiratory Distress as a Result of Cardiac and Pulmonary Issues
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作者 Patrick O’Connell 《Open Journal of Respiratory Diseases》 2015年第2期50-54,共5页
Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chr... Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chronic obstructive pulmonary disease (COPD) and asthma. Limitations to successful NIV and CPAP therapy were evaluated to determine how prolonged initiation of treatment may lead to hypoxemia (decreased oxygen in the blood) and hypercapnia (increased carbon dioxide in the blood) resulting in poor outcomes. Method: Reviews of literature from nursing and allied health data bases (CINAHL and ProQuest) with terms pulmonary edema, positive pressure device and non-invasive ventilation from 2010 to 2014 were used. Studies were conducted in the hospital and prehospital settings. Results: The literature search located 7 articles from CINAHL and 25 articles from ProQuest. A total of 6 of these articles were analyzed. Additional sources of data were obtained from Ignatavicius and Workman (2013) Medical-Surgical Nursing Patient-Centered Collaborative Care 7th edition and American Journal of Nursing (02/2013) Volume 113: 2. Conclusion: All of the articles concluded that early initiation of continuous positive airway pressure ventilations in the short-term was beneficial;however, late initiation of therapy required additional interventions. The studies indicated that early use of positive airway pressure in acute respiratory distress improved breath rate, heart rate and blood pressure. The use of positive airway pressure for respiratory distress may decrease the need for endotracheal intubation. 展开更多
关键词 Continuous Positive AIRWAY Pressure non-Invasive ventilation Acute PULMONARY EDEMA ASTHMA Chronic OBSTRUCTIVE PULMONARY Disease PREHOSPITAL Hospital
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分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响 被引量:1
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作者 丁艳 张东亚 张丹 《护士进修杂志》 2024年第10期1103-1106,1112,共5页
目的探究分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响。方法选取2020年1月—2022年12月在南京医科大学附属淮安第一医院呼吸与危重症医学科(pulmonary and critical care medicine,PCCM)治疗的102例呼吸衰竭患者为... 目的探究分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响。方法选取2020年1月—2022年12月在南京医科大学附属淮安第一医院呼吸与危重症医学科(pulmonary and critical care medicine,PCCM)治疗的102例呼吸衰竭患者为研究对象。采用随机数字表法将患者分为对照组和观察组,每组51例。对照组实施常规护理干预,观察组在对照组基础上实施分阶段式呼吸肌训练。分别于干预前和干预2周后比较2组患者撤机成功率、机械通气时间及呼吸肌力水平及氧合指数情况。结果干预2周后,观察组撤机成功率高于对照组,且机械通气时间短于对照组,差异均有统计学意义(P<0.05);干预后,2组最大口腔吸气压(MIP)、最大口腔呼气压(MEP)及氧合指数均高于干预前,且观察组高于同期对照组,差异有统计学意义(P<0.05)。结论分阶段式呼吸肌训练在临床护理中效果较好,可促进呼吸衰竭患者呼吸肌力恢复,改善膈肌功能,缩短机械通气时间,提高撤机成功率。 展开更多
关键词 呼吸肌训练 呼吸衰竭 无创通气 撤机成功率 护理
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1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理 被引量:1
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作者 龚艳艳 吴桃红 曹敏芝 《全科护理》 2024年第4期786-790,共5页
总结1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理经验。护理要点:无创呼吸机辅助通气治疗的护理、液体及营养支持管理、静脉血栓的预防及处理、预防和控制感染、联合康复科制订渐进式康复方案、出院指导与随... 总结1例心源性脑梗死后出血转化合并心肾综合征病人应用无创呼吸机治疗的护理经验。护理要点:无创呼吸机辅助通气治疗的护理、液体及营养支持管理、静脉血栓的预防及处理、预防和控制感染、联合康复科制订渐进式康复方案、出院指导与随访。经过21 d的精心治疗和护理,病人病情稳定,顺利转回当地医院继续康复治疗。 展开更多
关键词 急性脑梗死 出血转化 心肾综合征 无创机械辅助通气 护理
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无创机械通气联合呼吸训练在AECOPD合并呼吸衰竭患者中的应用评价
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作者 叶宁 罗淼 +1 位作者 秦燕 唐丽娟 《中国医学创新》 CAS 2024年第6期27-31,共5页
目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两... 目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两组。对照组(n=33)接受间断无创机械通气治疗,观察组(n=34)在对照组基础上增加主动呼吸训练(包括上肢弹力带阻抗训练、缩唇腹式呼吸、呼吸训练器使用)。记录两组2 d内撤机成功率、不良反应发生率,比较两组氧合指数(OI)、动脉血二氧化碳分压(PaCO_(2))、改良版英国医学研究委员会(mMRC)呼吸困难问卷分级、呼吸频率(RR)、自主呼吸潮气量。结果:对照组2 d内撤机成功率为60.6%,观察组为82.4%,观察组的撤机成功率高于对照组(P<0.05);观察组咳痰乏力、呼吸疲劳发生率均低于对照组(P<0.05);与治疗前相比,两组患者治疗2 d后的OI和PaCO_(2)均有显著改善,差异均有统计学意义(P<0.05);治疗2 d后,观察组PaCO_(2)低于对照组(P<0.05),但两组OI比较,差异无统计学意义(P>0.05);与治疗前相比,两组患者治疗2 d后的mMRC呼吸困难问卷分级和RR均有明显下降,自主呼吸潮气量均有明显提升,差异均有统计学意义(P<0.05);治疗2 d后,两组mMRC呼吸困难问卷分级和RR比较,差异均无统计学意义(P>0.05),但观察组患者自主呼吸潮气量明显高于对照组(P<0.05)。结论:AECOPD合并呼吸衰竭患者进行无创机械通气联合呼吸训练,能有效改善呼吸肌疲劳,增加肺通气,提高撤机成功率。 展开更多
关键词 无创机械通气 呼吸训练 慢性阻塞性肺疾病急性加重期 呼吸衰竭
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NICU早产儿无创正压通气护理质量评价指标的构建
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作者 邵方飞 郑翠翠 +2 位作者 金芳 王海英 吴玉梅 《全科护理》 2024年第12期2220-2225,共6页
目的:构建新生儿重症监护室(NICU)早产儿无创正压通气护理质量评价指标,为临床评价NICU早产儿无创正压通气护理质量提供依据。方法:以“结构-过程-结果”三维质量评价模型为基础,于2023年1月—4月采用德尔菲法对25名专家进行问卷函询,... 目的:构建新生儿重症监护室(NICU)早产儿无创正压通气护理质量评价指标,为临床评价NICU早产儿无创正压通气护理质量提供依据。方法:以“结构-过程-结果”三维质量评价模型为基础,于2023年1月—4月采用德尔菲法对25名专家进行问卷函询,并通过层次分析法确立NICU早产儿无创正压通气护理质量评价指标内容及各指标权重。结果:共开展2轮函询,问卷有效回收率分别为92.0%、100.0%,专家权威系数为0.922,0.928,肯德尔和谐系数为0.156,0.180。最终构建了3级结构模式评价指标,设有一级指标3项、二级指标14项、三级指标78项。结论:构建的无创正压通气护理质量评价指标内容科学、合理,具有较强的专科特色,可为早产儿无创正压通气护理质量评价提供参考依据。 展开更多
关键词 早产儿 无创正压通气 德尔菲法 护理质量 评价指标
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经鼻高流量氧疗对稳定期慢性阻塞性肺疾病合并高碳酸血症的疗效分析
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作者 叶青 田瑞雪 +1 位作者 侯洪颜 颜卫峰 《实用临床医药杂志》 CAS 2024年第14期67-71,76,共6页
目的分析经鼻高流量氧疗(HFNC)对稳定期慢性阻塞性肺疾病(COPD)合并高碳酸血症患者的干预效果。方法选取45例需长期氧疗的稳定期COPD合并高碳酸血症患者作为研究对象,根据不同呼吸支持模式分为长期家庭氧疗(LTOT)组、无创通气(NIV)组、H... 目的分析经鼻高流量氧疗(HFNC)对稳定期慢性阻塞性肺疾病(COPD)合并高碳酸血症患者的干预效果。方法选取45例需长期氧疗的稳定期COPD合并高碳酸血症患者作为研究对象,根据不同呼吸支持模式分为长期家庭氧疗(LTOT)组、无创通气(NIV)组、HFNC组,每组15例。比较3组患者出院后一般情况、血气指标、肺功能指标、呼吸状况、生活质量及步行试验结果。结果随访期内,HFNC组、NIV组住院次数、急性加重次数均少于LTOT组,差异有统计学意义(P<0.05);出院后6、12个月,3组动脉血二氧化碳分压[p_(a)(CO_(2))]低于出院前,动脉血氧分压[p_(a)(O_(2))]、脉搏血氧饱和度(SpO_(2))、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))高于出院前,且HFNC组上述指标变化程度大于NIV组、LTOT组,差异有统计学意义(P<0.05);出院后1、3、6、12个月,3组英国医学研究委员会呼吸困难量表(mMRC)评分、圣乔治呼吸问卷(SGRQ)评分均逐渐降低,6 min步行距离(6MWD)均逐渐增加,且HFNC组上述指标变化程度大于NIV组、LTOT组,差异有统计学意义(P<0.05)。结论HFNC可有效减轻稳定期COPD合并高碳酸血症患者呼吸困难症状,改善肺功能,促进血气指标恢复正常,还可提升生活质量和运动耐力,降低再入院率。 展开更多
关键词 慢性阻塞性肺疾病 高碳酸血症 家庭氧疗 无创通气 经鼻高流量氧疗 肺功能
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飞利浦V60无创呼吸机故障图像分析与解决方案研究
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作者 陆安 崔少康 甘扬清 《现代仪器与医疗》 CAS 2024年第3期91-96,共6页
我院重症监护室V60无创呼吸机在使用期间频发故障,本课题组经对2023年3月—7月期间的故障图像、数据、工作原理及系统组成进行深入分析,发现“主报警失败”和“100A”故障报警代码的具体原因。针对故障问题,本课题采取更换隔音棉材料、... 我院重症监护室V60无创呼吸机在使用期间频发故障,本课题组经对2023年3月—7月期间的故障图像、数据、工作原理及系统组成进行深入分析,发现“主报警失败”和“100A”故障报警代码的具体原因。针对故障问题,本课题采取更换隔音棉材料、固定通讯电缆线的方式,并实施预防性维护计划。改进措施实施后,同类型故障报修率大幅下降,显著提升了呼吸机的稳定性和可靠性。此外,本课题组的研究成果还为生产厂家提供了产品改良建议,为未来无创呼吸机的设计和管理提供了新思路。 展开更多
关键词 无创呼吸机 电路故障 技术分析 设备可靠性
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呼吸科护士无创正压通气护理知信行现状调查及分析
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作者 唐素芳 成静 +3 位作者 张国龙 杨旭 孙树云 覃彦珠 《全科护理》 2024年第14期2752-2756,共5页
目的:调查呼吸科护士无创正压通气(NIPPV)护理的知信行现状并分析呼吸科护士NIPPV护理行为的影响因素,为临床开展无创通气护理培训及管理提供依据。方法:采用自行设计的NIPPV护理知信行问卷对华南地区22所医院呼吸科的护士进行问卷调查... 目的:调查呼吸科护士无创正压通气(NIPPV)护理的知信行现状并分析呼吸科护士NIPPV护理行为的影响因素,为临床开展无创通气护理培训及管理提供依据。方法:采用自行设计的NIPPV护理知信行问卷对华南地区22所医院呼吸科的护士进行问卷调查,并分析NIPPV护理行为的影响因素。结果:共回收有效问卷215份,呼吸科护士NIPPV护理知信行总量表、知识维度、态度维度、行为维度得分分别为(98.29±12.51)分、(18.94±4.35)分、(28.44±4.75)分和(50.90±8.73)分。多元线性回归分析结果显示,NIPPV护理行为的主要影响因素为工作年限、是否接受过NIPPV护理知识或技能培训、所在科室是否有NIPPV护理流程规范、知识得分、态度得分。结论:呼吸科护士对无创通气护理的态度较为积极,无创通气护理的行为总体较好,但无创通气护理知识掌握程度有待提高。无创通气护理行为的主要影响因素为知识和态度、工作年限、是否接受过NIPPV护理知识或技能培训、所在科室是否有NIPPV护理流程规范。护理管理者应加强呼吸科护士的NIPPV护理知识和技能的培训,医疗机构应制订NIPPV护理操作流程规范,以规范护士的临床工作,提高NIPPV病人的护理质量。 展开更多
关键词 呼吸科护士 无创正压通气 护理 知信行 问卷调查 培训
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专职护理小组结合精细化护理在BiPAP呼吸机治疗慢阻肺急性加重期合并呼吸衰竭患者中的应用
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作者 华辉 王进静 夏彩霞 《包头医学院学报》 CAS 2024年第10期78-81,96,共5页
目的:分析专职护理小组结合精细化护理在无创正压通气(non-invasive positive pressure ventilation,NPPV)呼吸机治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患... 目的:分析专职护理小组结合精细化护理在无创正压通气(non-invasive positive pressure ventilation,NPPV)呼吸机治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者中的应用价值。方法:选取江苏省东台市人民医院2021年4月至2022年4月BiPAP(bilevel positive airway pressure,BiPAP)呼吸机治疗的AECOPD合并呼吸衰竭患者82例,随机分为对照组(n=41)、观察组(n=41),对照组为常规护理,观察组为专职护理小组结合精细化护理,比较两组患者肺功能、血气指标及并发症发生率。结果:护理前,两组患者肺功能比较差异无统计学意义(P>0.05),护理后观察组更优(P<0.05);护理前,两组患者血气指标比较差异无统计学意义(P>0.05),护理后观察组较对照组更优(P<0.05),且观察组患者并发症发生率较对照组更低(P<0.05)。结论:对AECOPD合并呼吸衰竭患者,采用专职护理小组结合精细化护理可改善肺功能、血气指标,降低并发症发生率。 展开更多
关键词 专职护理小组 精细化护理 无创正压通气呼吸机 慢性阻塞性肺疾病
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尿素氮/白蛋白对慢性阻塞性肺疾病加重期合并肾功不全通气的预测价值
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作者 韩红 刘珊 +2 位作者 刘晓东 刘红 刘张波 《心肺血管病杂志》 CAS 2024年第9期939-944,共6页
目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasi... 目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasive mechanical ventilation,NIV)预后的预测价值。方法:选择2021年1月至2023年1月,在连云港市第二人民医院肾内科,收治的老年AECOPD合并肾功能不全患者接受NIV患者220例,依据患者住院NIV治疗后28 d的生存情况分为:生存组(180例)和死亡组(40例),比较两组患者的B/A,运用Logistic回归性分析和受试者工作特征曲线ROC评价入院初24 h的B/A预测AECOPD合并肾功能不全患者NIV治疗后28 d预后的价值。结果:生存组白蛋白、血红蛋白和血小板显著高于死亡组患者(P <0.05),生存组尿素氮、B/A、急性生理和慢性健康评分(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)显著低于死亡组患者(P <0.05)。Logistic回归分析结果显示B/A和APACHEⅡ评分是导致患者死亡的危险因素(P <0.05)。ROC分析显示,B/A的曲线下面积、敏感度、特异度均较APACHEⅡ评分增高,B/A与APACHEⅡ评分的AUC差异无统计学意义(t=1.686,P=0.093)。结论:B/A和APACHEⅡ评分均可用于评估老年AECOPD合并肾功能不全患者NIV预后,与APACHEⅡ评分比,B/A在评估老年AECOPD患者NIV预后的效能更高。 展开更多
关键词 慢性阻塞性肺疾病急性加重期 肾功能不全 尿素氮与白蛋白比值 无创机械通气 预后
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综合护理干预对阻塞性睡眠呼吸暂停低通气综合征患者生命质量的作用
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作者 净卫娟 郝丽娟 +3 位作者 潘丽杰 袁晓敏 马清芸 李旭凌 《世界睡眠医学杂志》 2024年第3期621-624,共4页
目的:探讨综合护理干预对青海地区阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者生命质量的改善效果。方法:选取2019年1月至2021年12月在青海红十字医院睡眠医学科行多导睡眠监测(PSG)和无创呼吸机治疗的中重度OSAHS住院患者392例作为研... 目的:探讨综合护理干预对青海地区阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者生命质量的改善效果。方法:选取2019年1月至2021年12月在青海红十字医院睡眠医学科行多导睡眠监测(PSG)和无创呼吸机治疗的中重度OSAHS住院患者392例作为研究对象,根据收治的时间登记表单双号顺序将患者分为对照组(单号)和观察组(双号),每组196例。对照组给予普通护理,观察组给予综合护理。比较2组干预前后Epworth嗜睡量表(ESS)、焦虑自评量表(SAS)、睡眠呼吸暂停生命质量指数(SAQLl)评分及干预后持续气道正压通气(CPAP)治疗依从性。结果:干预后,2组患者ESS、SAS评分均低于本组干预前(均P<0.05),且观察组干预后ESS、SAS评分均低于对照组(均P<0.05)。干预后,2组患者SAQLI日常活动、社会影响、情感活动、症状评分均高于本组干预前(均P<0.05),且观察组干预后SAQLI日常活动、社会影响、情感活动、症状评分均高于对照组(均P<0.05)。观察组干预后完成CPAP治疗患者例数明显多于对照组(P<0.05)。结论:综合护理干预后可显著提高患者CPAP治疗的依从性,提高疗效,提高患者的生命质量。 展开更多
关键词 阻塞性睡眠呼吸暂停综合征 综合护理 持续气道正压通气 生命质量 睡眠 焦虑 依从性 青海地区
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基于室内非均匀环境营造的新型通风模式下人员热舒适性及系统节能潜力
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作者 于水 吴平一 韩府宏 《暖通空调》 2024年第10期86-95,149,共11页
为解决现有通风空调系统无法根据占用区域实现按需供冷造成的热不舒适及能源浪费问题,本研究根据人员占用区域需求实时切换气流模式组合及冷量供给,提出了一种新型通风模式,旨在利用多种气流模式的最优组合控制特定需求场景。采用数值... 为解决现有通风空调系统无法根据占用区域实现按需供冷造成的热不舒适及能源浪费问题,本研究根据人员占用区域需求实时切换气流模式组合及冷量供给,提出了一种新型通风模式,旨在利用多种气流模式的最优组合控制特定需求场景。采用数值模拟的方法探究了不同占用区域情况下新型通风模式的人员热舒适性和系统的节能潜力,并与混合通风模式和层式通风模式进行了对比。结果表明:新型通风模式在气流组织上具有明显优势;新型通风模式较混合通风模式和层式通风模式具有更高的热舒适性,空气分布特性指数最大;新型通风模式局部冷量利用系数最小,冷量有效利用率最高,所需供冷量最小,因此新型通风模式的节能潜力最大。 展开更多
关键词 非均匀环境 新型通风模式 热舒适性 节能潜力 气流组织 按需供冷 占用区域
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经鼻高流量湿化治疗仪治疗慢阻肺急性加重期伴呼吸性酸中毒患者的效果
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作者 赵红侠 董伟 +2 位作者 杨美艳 庞宇 李凌维 《中外医学研究》 2024年第14期62-66,共5页
目的:分析经鼻高流量湿化治疗仪应用于慢阻肺急性加重期伴呼吸性酸中毒的治疗效果,探讨其对患者血气指标及肺功能的影响。方法:回顾性分析2022年1月—2023年10月在北京市昌平区医院呼吸与危重症学科治疗的100例慢阻肺急性加重伴呼吸性... 目的:分析经鼻高流量湿化治疗仪应用于慢阻肺急性加重期伴呼吸性酸中毒的治疗效果,探讨其对患者血气指标及肺功能的影响。方法:回顾性分析2022年1月—2023年10月在北京市昌平区医院呼吸与危重症学科治疗的100例慢阻肺急性加重伴呼吸性酸中毒患者的临床资料。根据治疗方式的不同分为两组,各50例。观察组接受经鼻高流量湿化氧疗,对照组接受无创正压通气治疗。比较两组的血气指标、肺功能指标、治疗效果及不良反应发生情况。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组血气指标、肺功能指标比较,差异无统计学意义(P>0.05);治疗后,两组pH值、氧分压(PaO_(2))、氧合指数(OI)均高于治疗前,二氧化碳分压(PaCO_(2))低于治疗前,且观察组pH值、PaO_(2)、OI高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗后,两组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰流速值(PEF)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC%)均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:经鼻高流量湿化氧疗、无创正压通气治疗都是慢阻肺急性加重期伴呼吸性酸中毒辅助通气的有效方法,而经鼻高流量湿化氧疗可有效提高治疗效果,改善患者血气指标及肺功能,不良反应少,安全性更高。 展开更多
关键词 慢阻肺急性加重期伴呼吸性酸中毒 经鼻高流量湿化氧疗 无创正压通气 动脉血气指标 肺功能
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