頁籤選單縮合
題 名 | Alterations in Respiratory Mechanics in Mechanically Ventilated Patients Following Bronchoalveolar Lavage |
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作 者 | Chou, Meng-yi; Ou, Chih-ying; Chen, Chang-wen; | 書刊名 | Journal of the Formosan Medical Association |
卷 期 | 108:9 2009.09[民98.09] |
頁 次 | 頁704-712 |
分類號 | 415.41 |
關鍵詞 | Bronchoalveolar lavage; Intrinsic positive end-expiratory pressure; Mechanical ventilation; |
語 文 | 英文(English) |
英文摘要 | Background/Purpose Bronchoalveolar lavage (BAL) can be used for a variety of diagnostic purposes in mechanically ventilated patients. BAL can cause changes in respiratory mechanics. However, the risk factors associated with these changes remain unknown. The current study tried to identify the risk factors that contribute to changes in respiratory mechanics following BAL. Methods Changes in respiratory mechanics were assessed in 56 mechanically ventilated patients who received BAL using an interrupter method under constant flow. Results Intrinsic positive end-expiratory pressure (PEEPi) was correlated significantly with changes in respiratory system resistance and compliance following BAL in mechanically ventilated patients (p = 0.003). In 14 patients with PEEPi > 1 cmH2O, maximal resistance (Rmax) before BAL was 22.5 ± 5.9 cmH2O/L/S, increasing to 31.6 ± 8.5 cmH2O/L/S immediately after BAL, and remaining high (28.4 ± 7.5 cmH2O/L/S) 30 minutes later (p < 0.001). Increase in minimal resistance (Rmin), delta resistance (ΔR), and decrease in compliance followed the same time trend. In 42 patients with PEEPi £ 1 cmH2O, Rmax before BAL was 15.5 ± 3.5 cmH2O/L/S, increasing to 17.6 ± 4.6 cmH2O/L/S immediately after BAL, and decreasing to 16.6 ± 4.3 cmH2O/L/S (p < 0.001) 30 minutes later. Increase in Rmin, ΔR and decrease in compliance were similar to those seen with Rmax. Increases in Rmax, Rmin and ΔR, and decrease in compliance following BAL were significantly higher in patients with significant PEEPi than in those without throughout the recording period (p < 0.001). Conclusion Patients with significant PEEPi experienced greater changes in respiratory mechanics than those without. Physicians should be cautious when performing BAL in such patients. |
本系統中英文摘要資訊取自各篇刊載內容。