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題 名 | 壓力支持通氣模式對急性呼吸衰竭患者之影響=Effect of Pressure Support Ventilation Mode in Patients of Acute Respiratory Failure |
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作 者 | 蘇千玲; 楊式興; 吳清平; | 書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 4:3 2002.07[民91.07] |
頁 次 | 頁154-161 |
分類號 | 415.22 |
關鍵詞 | 壓力通氣模式; 呼吸器; 呼吸衰竭; Pressure control; Ventilator; Acute respiratory failure; |
語 文 | 中文(Chinese) |
中文摘要 | 以壓力為主通氣模式包括:壓力控制模式(pressure control mode,PC)、壓力調節容積控制模式(Pressure Regulated Volume Control,PRVC)、壓力支持通氣模式(Pressure Support Ventilation,PSV),急性期患者多使用壓力控制模式,以降低病人呼吸做功,而臨床對於急性期使用呼吸器患者,應用PSV模式相關性探討仍缺乏,PSV模式是由病人所啟動,因此我們以為對於肺部有變化的急性呼吸衰竭之病患,除了完全支持壓力控制模式外,應同樣適用PSV模式。 11位急性呼吸衰竭患者隨機使用PC、PRVC及PSV三種模式,比較呼吸型態與呼吸用力之差異,研究結果顯示:PSV之潮氣容積顯著高於另二種模式,其中4位阻塞性肺疾病患者除了潮氣容積顯著增高外,與PC、PRVC相比PSV模式呼吸次數和呼吸快淺指標皆有顯著降低的情形。因此我們認為,PSV模式可有效降低病人吸氣作功、改善呼吸型態和適應用於急性呼吸衰竭、血液動力學穩定之病患。 |
英文摘要 | The mechanical ventilation is often applied to the patients with acute respiratory failure. Many data showed the benefits of mandatory modes. Little approach is made to pressure-support model (PS) in acute respiratory failure. There are another two pressure-target ventilation modes, pressure-regulated volume control (PRVC) and pressure control (PC), being frequently applied to patients. Based on the consideration of their same pressure target, but not the cycle of flow, we attempted to compare these three modes for patients with acute respiratory failure. Eleven patients with acute respiratory failure in ICU were recruited. Flow, proximal airway pressure, and esophageal pressure were measured through a pneumotachography/ pressure transducer and esophageal balloon catheter. Patients were in semi-recumbent position. The ventilatory modes was randomized to PS, PC, or PRVC. The following variables were measured: tidal volume (V□), respiratory frequency (RR), rapid shallow index (RR/ V□), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), minute ventilation (MV), peak inspiratory pressure, work of breathing (WOB), airway occlusion pressure (P0.1), pressure time product (PTP), intrinsic PEEP (PEEP[93bc]]), static compliance (Cst) and resistance (Rrs) of respiratory system. We compared the breathing pattern and breathing effort among these three modes. The VT was 0.65±0.2 liter in the PS mode, which was significantly higher than those in the PRVC and PC modes (0.49±0.07 and 0.49±0.08 liter, respectively). The breathing effort, including WOB, P0.1, and PTP, were not significantly different among modes. We then analyzed the data in 4 COPD patients. The V□, RR, MV and RR/V□ in pressure support were significant different from those using PRVC or PC modes. Our results showed that the breathing pattern and effort among these pressure-target modes are not different in patients with acute respiratory failure, but V□ significant different in COPD patients. |
本系統中英文摘要資訊取自各篇刊載內容。