临床环境中机械呼吸机准确性评价:一项质量控制研究

H. Al-Otaibi, K. Ansari, F. Farooqi
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摘要

背景:机械呼吸机(MV)是重症监护病房最重要的设备之一。不适当的呼吸机设置可能会对患者的健康产生不利影响。本研究的目的是评估临床环境中呼吸机提供的体积、压力和流量的准确性。材料与方法:从沙特阿拉伯东部省份随机选取的四家主要医院随机选取30名mv。所有类型的现代重症监护病房呼吸机品牌以及所有版本的目标。采用Fluke Biomedical VT PLUS HF气体流量分析仪对压力、体积和流量进行两个水平的评估。结果:高压平均28.7±4.9 cm H2O,低压平均14.6±1.3 cm H2O。在高压下,测量值与设定值之间的95%一致限(LA95%)为−0.74-2.86 cm H2O,在低压下为−0.114-0.84 cm H2O。平均容积测量值高设置为676.9±45.5 ml,低设置为342.9±24 ml。高流量时la95%为104.76 ~ 138.05 ml,低流量时la95%为47.7 ~ 65.3 ml,高流量平均值为53.4±4.6 lpm, la95%为3.3 ~ 6.8 lpm,低流量平均值为36±3.7 lpm, la95%为1.87 ~ 4.6 lpm。结论:目前的数据显示,在临床设置的mv有一些差异的表现。交付的流量和体积可能不像预期的那样准确。在重症患者中使用时应考虑到这些差异。
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Evaluation of mechanical ventilators' accuracy in clinical settings: A quality control study
Background: A mechanical ventilator (MV) is one of the most important devices in critical care units. Improper ventilator settings may adversely affect patients' health. The objective of this study is to evaluate the accuracy of volume, pressure, and flow delivered by the ventilators in clinical settings. Materials and Methods: Thirty randomly chosen MVs from four randomly selected main hospitals in the eastern province of Saudi Arabia were included in this study. All types of modern intensive care unit ventilators brands along with all versions were targeted. Pressure, volume, and flow were evaluated at two levels by using Fluke Biomedical VT PLUS HF Gas Flow Analyzer. Results: High-pressure mean was 28.7 ± 4.9 cm H2O and low-pressure mean was 14.6 ± 1.3 cm H2O. 95% limits of agreement (LA95%) between the measured and setting in high pressure was −0.74–2.86 cm H2O and −0.114–0.84 cm H2O in low pressure. The mean of volume measurements was 676.9 ± 45.5 ml in high setting and 342.9 ± 24 ml in low setting. In high volume setting, LA95%of 104.76–138.05 ml, wherein low volume LA95%of 47.7–65.3 ml. High flow mean was 53.4 ± 4.6 lpm with LA95%of 3.3–6.8 lpm and low flow mean was 36 ± 3.7 lpm with LA95%of 1.87–4.6 lpm. Conclusion: The present data reveal that MVs in clinical settings have some variations in their performance. The delivered flow and volume might not be accurate as it might be anticipated. These differences should be considered while their use in critically ill patients.
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