P010通过气管切开术给予容积保证压力支持(VAPS)的儿科患者

A O'Connor, V Saddi, G Thambipillay, A Teng
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引用次数: 0

摘要

体积保证压力支持(VAPS)允许呼吸机通过在设定范围内自动调节吸气压力来提供恒定的预先设定的潮气量或肺泡通气,提供有针对性的压力支持。关于其在儿童中的使用的数据有限。我们描述了四名儿童通过气管切开术,使用VAPS模式进行有效、安全的通气。方法回顾性分析患者记录。在我们的队列中,有4例儿童患者通过气管切开术成功安全地使用VAPS模式通气。患者年龄在6-14岁之间,有四种不同的潜在疾病过程——普瑞德-威利综合征、先天性中央性低通气综合征、格林-巴罗综合征和莫比乌斯型综合征。预期结果和影响虽然之前有儿科病例报告和病例系列证明了无创使用VAPS模式的有效性,但在最近的一个病例系列中,仅描述了使用VAPS模式通过气管切开术为儿童提供有效和安全的通气。与传统的双水平气道正压支持相比,其优点包括能够补偿潮气量的变化,潮气量的变化可能随着肺顺应性的变化和睡眠的不同阶段而发生。本病例系列强调在气管切开术患儿中安全有效地使用VAPS模式。
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P010 Delivery of volume assured pressure support (VAPS) through tracheostomy in paediatric patients
Abstract INTRODUCTION Volume assured pressure support (VAPS) allows the ventilator to deliver a constant pre-set tidal volume or alveolar ventilation by automatically adjusting the inspiratory pressures within a set range, providing targeted pressure support. Data on its use in children are limited. We describe a series of four children effectively and safely ventilated using VAPS mode through tracheostomy. METHODS Retrospective review of patient notes. PROGRESS TO DATE Four paediatric patients were identified in our cohort who were successfully and safely ventilated using the VAPS mode through tracheostomy. The patients were between 6-14 years of age inclusive, with four differing underlying disease processes – Prader-Willi syndrome, congenital central hypoventilation syndrome, Guillain-Barré syndrome and Moebius-type syndrome. INTENDED OUTCOME AND IMPACT Whilst there have been previous paediatric case reports and case series which have demonstrated efficacy of VAPS mode used non-invasively, the use of VAPS mode to provide effective and safe ventilation through tracheostomy in children has been described in only one recent case series. The advantages of its use over conventional bilevel positive airway pressure support include its ability to compensate for changes in tidal volume, which can occur with changes in lung compliance and during different stages of sleep. This case series highlights safe and effective use of VAPS mode in children with tracheostomy.
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