定量比较不同呼吸机分流和多路复用方法的通气参数。

Q4 Medicine Critical care explorations Pub Date : 2024-06-25 eCollection Date: 2024-07-01 DOI:10.1097/CCE.0000000000001113
Doowon Kim, Steven Roy, Paul McBeth, Jihyun Lee
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引用次数: 0

摘要

背景:在 COVID-19 大流行的背景下,本研究深入探讨了呼吸机的短缺问题,探讨了简单分割通气(SSV)、简单差分通气(SDV)和差分多通气(DMV)。知识缺口的核心是了解它们的性能和安全影响:我们假设 SSV、SDV 和 DMV 可为呼吸机危机提供解决方案。预计严格的测试将揭示其优势和局限性,从而帮助开发有效的通气方法:方法和模型:使用专用试验台对 SSV、SDV 和 DMV 进行了比较。在受控环境中模拟肺部,便于使用传感器进行测量。统计分析主要针对吸气峰压(PIP)和呼气末正压等参数:将肺 1 和肺 2 的目标 PIP 分别设定为 15 cm H2O 和 12.5 cm H2O,SSV 显示两肺的 PIP 均为 15.67 ± 0.2 cm H2O,潮气量(Vt)均为 152.9 ± 9 mL。在 SDV 试验中,肺 1 的 PIP 为 25.69 ± 0.2 cm H2O,肺 2 为 24.73 ± 0.2 cm H2O,潮气量分别为 464.3 ± 0.9 mL 和 453.1 ± 10 mL。DMV 试验显示,肺 1 的 PIP 为 13.97 ± 0.06 cm H2O,肺 2 为 12.30 ± 0.04 cm H2O,Vts 分别为 125.8 ± 0.004 mL 和 104.4 ± 0.003 mL:这项研究丰富了人们对呼吸机共享策略的理解,强调了谨慎选择的必要性。DMV 在保持回路连续性的同时,还能提供个性化服务,因此脱颖而出。研究结果为制定稳健的多路复用策略奠定了基础,从而加强了危机情况下的呼吸机管理。
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Quantitative Comparison of Ventilation Parameters of Different Approaches to Ventilator Splitting and Multiplexing.

Context: Amid the COVID-19 pandemic, this study delves into ventilator shortages, exploring simple split ventilation (SSV), simple differential ventilation (SDV), and differential multiventilation (DMV). The knowledge gap centers on understanding their performance and safety implications.

Hypothesis: Our hypothesis posits that SSV, SDV, and DMV offer solutions to the ventilator crisis. Rigorous testing was anticipated to unveil advantages and limitations, aiding the development of effective ventilation approaches.

Methods and models: Using a specialized test bed, SSV, SDV, and DMV were compared. Simulated lungs in a controlled setting facilitated measurements with sensors. Statistical analysis honed in on parameters like peak inspiratory pressure (PIP) and positive end-expiratory pressure.

Results: Setting target PIP at 15 cm H2O for lung 1 and 12.5 cm H2O for lung 2, SSV revealed a PIP of 15.67 ± 0.2 cm H2O for both lungs, with tidal volume (Vt) at 152.9 ± 9 mL. In SDV, lung 1 had a PIP of 25.69 ± 0.2 cm H2O, lung 2 at 24.73 ± 0.2 cm H2O, and Vts of 464.3 ± 0.9 mL and 453.1 ± 10 mL, respectively. DMV trials showed lung 1's PIP at 13.97 ± 0.06 cm H2O, lung 2 at 12.30 ± 0.04 cm H2O, with Vts of 125.8 ± 0.004 mL and 104.4 ± 0.003 mL, respectively.

Interpretation and conclusions: This study enriches understanding of ventilator sharing strategy, emphasizing the need for careful selection. DMV, offering individualization while maintaining circuit continuity, stands out. Findings lay the foundation for robust multiplexing strategies, enhancing ventilator management in crises.

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CiteScore
5.70
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审稿时长
8 weeks
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