Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature gener...Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature generates an increase in intraabdominal pressure that causes an increase in intrathoracic pressure. Pressure, volume, flow, and respiratory rate are components of a unique physical variable, the mechanical power (MP), and is an integrated variable linked to most factors related to postoperative pulmonary complications. Purpose: To assess the effect of rectus plication (RP) during abdominoplasty on lung pressures and the contribution to increasing the MP. Method: A open-label study was conducted at TJ Plast Advanced Center for Plastic Surgery in Tijuana, México, from September 2021 to May 2022. The study included forty-six female patients subjected to abdominoplasty or liposuction with abdominoplasty. After the induction of general anesthesia and neuromuscular blockade, they were allocated into two groups: Group 1 pressure control ventilation-volume guaranteed (PCV-VG) and Group 2 volume control ventilation (VCV). Respiratory pressures and MP were assessed before and after RP. Results: During VCV, patients had a greater increase in peak pressure (PIP) (P 0.000). Plateau pressure (P<sub>plat</sub>) increased 1.78 ± 0.35 cmH<sub>2</sub>O in group 2 after RP (P = 0.001). MP had a greater increase in group 2 after RP (P 0.01). Conclusion: This prospective study showed that RP is related to an increase in PIP and P<sub>plat</sub> and an increase in the MP better controlled with PCV-VG ventilation.展开更多
目的研发一种具有高效过滤和恒定泄气量功能(EFCL)的无创正压通气(NPPV)面罩,并探讨其有效性。方法进行EFCL面罩发明设计,并完成其产品制造。将20例健康人作为研究对象,根据不同面罩类型分为两组:试验组采用EFCL面罩;对照组采用传统NPP...目的研发一种具有高效过滤和恒定泄气量功能(EFCL)的无创正压通气(NPPV)面罩,并探讨其有效性。方法进行EFCL面罩发明设计,并完成其产品制造。将20例健康人作为研究对象,根据不同面罩类型分为两组:试验组采用EFCL面罩;对照组采用传统NPPV面罩和侧孔型呼气阀的组合。每个研究对象均采用试验组和对照组的前后交叉研究。在标准化试验条件及呼气气道正压(EPAP)为5、10 cm H_(2)O条件下,监测两组面罩内呼气末二氧化碳分压(Pet CO_(2));吸气气道正压(IPAP)从5 cm H_(2)O逐步递增至10、15、20 cm H_(2)O时,监测两组各节点呼气阀泄气量;评价两组面罩操作性和舒适性。结果在相同EPAP水平(5 cm H_(2)O或10cm H_(2)O),试验组面罩内Pet CO_(2)均显著低于对照组(均P<0.05);IPAP从5 cm H_(2)O逐步递增至20 cm H_(2)O时,试验组呼气阀泄气量维持相对恒定,对照组呼气阀泄气量则随IPAP压力增高而增加。两组面罩的操作性、舒适性均具有较高的满意率和一致性。结论EFCL面罩具有高效过滤和恒定泄气量的功能,为降低NPPV面罩应用中的交叉感染风险提供新方法。展开更多
目的:评价在机械通气中应用囊内压测定法的疗效。方法:我们通过检索近10年Cochrane Library、Medline、Pubmed、Web of Science、万方数据库、维普中文科技期刊全文数据库、中国学术期刊全文数据库,对纳入研究的方法学进行评价。研究者...目的:评价在机械通气中应用囊内压测定法的疗效。方法:我们通过检索近10年Cochrane Library、Medline、Pubmed、Web of Science、万方数据库、维普中文科技期刊全文数据库、中国学术期刊全文数据库,对纳入研究的方法学进行评价。研究者对纳入文献的质量进行严格评价和资料提取,使用Review manager 5.0软件对符合质量标准的RCT行系统评价。结果:6个RCT共272名患者纳入研究,其中治疗组(使用囊内压测定法)135例,对照组(使用固定注气法)137例,2组患者均行常规对症支持治疗。系统评价结果表明,与对照组相比,治疗组患者8h后气道损伤、8h后误吸呛咳、2d气囊破裂漏气的发生率差异具有统计学意义。结论:囊内压测定法可显著提高患者机械通气的疗效。展开更多
文摘Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature generates an increase in intraabdominal pressure that causes an increase in intrathoracic pressure. Pressure, volume, flow, and respiratory rate are components of a unique physical variable, the mechanical power (MP), and is an integrated variable linked to most factors related to postoperative pulmonary complications. Purpose: To assess the effect of rectus plication (RP) during abdominoplasty on lung pressures and the contribution to increasing the MP. Method: A open-label study was conducted at TJ Plast Advanced Center for Plastic Surgery in Tijuana, México, from September 2021 to May 2022. The study included forty-six female patients subjected to abdominoplasty or liposuction with abdominoplasty. After the induction of general anesthesia and neuromuscular blockade, they were allocated into two groups: Group 1 pressure control ventilation-volume guaranteed (PCV-VG) and Group 2 volume control ventilation (VCV). Respiratory pressures and MP were assessed before and after RP. Results: During VCV, patients had a greater increase in peak pressure (PIP) (P 0.000). Plateau pressure (P<sub>plat</sub>) increased 1.78 ± 0.35 cmH<sub>2</sub>O in group 2 after RP (P = 0.001). MP had a greater increase in group 2 after RP (P 0.01). Conclusion: This prospective study showed that RP is related to an increase in PIP and P<sub>plat</sub> and an increase in the MP better controlled with PCV-VG ventilation.
文摘目的研发一种具有高效过滤和恒定泄气量功能(EFCL)的无创正压通气(NPPV)面罩,并探讨其有效性。方法进行EFCL面罩发明设计,并完成其产品制造。将20例健康人作为研究对象,根据不同面罩类型分为两组:试验组采用EFCL面罩;对照组采用传统NPPV面罩和侧孔型呼气阀的组合。每个研究对象均采用试验组和对照组的前后交叉研究。在标准化试验条件及呼气气道正压(EPAP)为5、10 cm H_(2)O条件下,监测两组面罩内呼气末二氧化碳分压(Pet CO_(2));吸气气道正压(IPAP)从5 cm H_(2)O逐步递增至10、15、20 cm H_(2)O时,监测两组各节点呼气阀泄气量;评价两组面罩操作性和舒适性。结果在相同EPAP水平(5 cm H_(2)O或10cm H_(2)O),试验组面罩内Pet CO_(2)均显著低于对照组(均P<0.05);IPAP从5 cm H_(2)O逐步递增至20 cm H_(2)O时,试验组呼气阀泄气量维持相对恒定,对照组呼气阀泄气量则随IPAP压力增高而增加。两组面罩的操作性、舒适性均具有较高的满意率和一致性。结论EFCL面罩具有高效过滤和恒定泄气量的功能,为降低NPPV面罩应用中的交叉感染风险提供新方法。
