神经调节辅助通气在重症创伤性湿肺合并ARDS患者中的应用

发布时间：2019-06-07 10:58

【摘要】：目的:探索在重症创伤性湿肺(STWL)患者中应用神经电活动辅助通气(NAVA)模式与传统压力支持通气(如PSV)模式相比较时,其人机同步性、呼吸力学、气体交换能力、血流动力学上的差异。方法:以18例需机械通气的重症创伤性湿肺患者为研究对象,每例患者随机先任选NAVA或PSV模式进行机械通气120min,再换用另一种通气模式。比较同一患者在两种通气模式下,其人机同步性、呼吸力学、气体交换能力、血流动力学等方面的不同。结果:18例患者的血流动力学(HR、CVP)及气体交换能力(动脉血pH值、PaO2、PaCO2、SaO2)在两种模式间无明显差异(P0.05),在人机同步性(Trigger delay、Off cycle delay)及呼吸力学(PIP、Pmean)方面NAVA优于PSV,差异具有显著性(P0.05)。结论:对于重症创伤性湿肺机械通气患者,NAVA模式比PSV模式,具有人机协调性高、呼吸力学稳定等优势,而在血流动力学及气体交换能力上具有相似的安全性。
[Abstract]:Objective: to explore the man-machine synchronization, respiratory mechanics and gas exchange ability of neuroelectrical activity-assisted ventilation (NAVA) model compared with traditional pressure-supported ventilation (such as PSV) mode in patients with severe traumatic wet lung (STWL). Hemodynamic differences. Methods: 18 patients with severe traumatic wet lung who needed mechanical ventilation were randomly selected for mechanical ventilation in NAVA or PSV mode for 120 min, and then another ventilation mode. The differences of man-machine synchronization, respiratory mechanics, gas exchange capacity and hemodynamics in the same patient under the two ventilation modes were compared. Results: there was no significant difference in hemodynamics (HR,CVP) and gas exchange capacity (PaO2,PaCO2,SaO2) between the two models (P 0.05), but there was no significant difference in man-machine synchronization (Trigger delay,Off cycle delay) and respiratory mechanics (PIP,). There was significant difference between NAVA and PSV, in Pmean (P 0.05). Conclusion: for patients with severe traumatic wet lung mechanical ventilation, NAVA mode has the advantages of higher human-computer coordination and stable respiratory mechanics than PSV mode, and has similar safety in hemodynamics and gas exchange ability.
【作者单位】：天津医科大学一中心临床学院ICU;
【基金】：天津市卫生局科技基金(2010KY07)
【分类号】：R655;R563.8

【共引文献】