闭环通气模式脱机方法对慢性阻塞性肺疾病脱机的影响

发布时间：2018-11-04 18:23

【摘要】：目的比较闭环通气模式适应性支持通气(ASV)与智能化脱机Smart Care/PS两种脱机方法对慢性阻塞性肺疾病(COPD)患者机械通气脱机的疗效。方法采用前瞻性随机对照研究,将2012年3月至2014年3月哈尔滨医科大学附属第一医院ICU60例COPD机械通气患者纳入观察。随机数字法分为适应性支持通气组(ASV组,30例)和智能化Smart Care/PS组(SC组,30例)进行脱机。两组患者除撤机方法不同外,其他处理均相同,记录每位患者的脱机时间、总机械通气时间、脱机成功率、再插管率以及ICU住院时间、ICU病死率。脱机成功标准为脱机拔管48 h以上未再进行机械通气。结果 ASV组的脱机时间、总机械通气时间少于SC组(P=0.000 2、0.046),但ICU住院时间与SC组比较差异无统计学意义(P=0.170)。ASV组的脱机成功率高于SC组(P=0.030),但脱机48 h后接受无创通气率及再插管率ICU住院病死率和总住院病死率组间比较差异无统计学意义(P0.05)。结论可以通过闭环通气模式对COPD患者进行脱机,适应性支持通气模式可能略优于Smart Care/PS模式。
[Abstract]:Objective to compare the efficacy of adaptive support ventilation (ASV) and intelligent offline Smart Care/PS (Smart Care/PS) in patients with chronic obstructive pulmonary disease (COPD). Methods A prospective randomized controlled study was conducted to observe ICU60 patients with COPD mechanical ventilation in the first affiliated Hospital of Harbin Medical University from March 2012 to March 2014. The patients were divided into adaptive support ventilation group (ASV group, 30 cases) and intelligent Smart Care/PS group (SC group, 30 cases). Except for the different methods of weaning, all the other treatments were the same. The weaning time, total mechanical ventilation time, offline success rate, re-intubation rate, ICU hospitalization time and ICU mortality were recorded. The successful standard of offline extubation was no mechanical ventilation for more than 48 hours. Results the total duration of mechanical ventilation in ASV group was less than that in SC group (P0. 000 2 卤0. 046), but there was no significant difference between ICU group and SC group (P 0. 170). ASV group was higher than SC group (P0. 030). However, there was no significant difference between the two groups in hospital mortality (ICU) and total hospital mortality (P 0.05) after 48 hours of weaning and receiving non-invasive ventilation rate and re-intubation rate (P 0.05). Conclusion closed loop ventilation can be used to wean patients with COPD, and adaptive support ventilation may be a little better than Smart Care/PS.
【作者单位】：哈尔滨医科大学附属第一医院重症医学科;
【基金】：黑龙江省卫生厅课题(2013019)
【分类号】：R563.8

【共引文献】