危重患者机械通气脱机时压力支持通气与比例辅助通气的比较

IF 0.2 Q4 RESPIRATORY SYSTEM Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI:10.5005/jp-journals-11010-02207
Sanjay Sasikumar, V. Shanbhag, A. Shenoy
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引用次数: 2

摘要

背景:压力支持通气(PSV)是一种广泛使用的断奶模式,可随着肺部特征的变化提供不同程度的支持。比例辅助通气+(PAV+)是一种新模式,可根据呼吸系统的变化进行自动调整。目的:本研究比较PSV和PAV+对机械通气断奶的影响。方法:这是一项前瞻性随机对照研究,纳入23名成年患者,在通过SBT标准和30分钟的PSV试验后至少机械通气48小时。他们被随机分为接受PAV+(第1组)或PSV(第2组)。任何一组患者的冲洗时间为30分钟,以抵消先前PSV模式的影响。在SBT准备状态评估期间,以及在随机断奶模式下60分钟后,采集两份动脉血气样本。注意到呼吸窘迫的临床症状和客观的断奶标准。记录断奶的成功率和持续时间、快速浅呼吸指数(RSBI)、快速浅吸气指数率(RSBI率)、血液动力学和呼吸参数。结果:13例患者随机分为PAV+组;PSV组10例。两组的人口统计数据相似。RSBI、RSBI率、动脉血气分析、峰值和平均吸气压力在两组中均无差异。两组的ICU平均住院时间、断奶时间和拔管天数几乎相似。结论:PAV+模式和PSV模式在准备断奶的患者中可以同等有效地使用。
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Comparison of pressure support ventilation and proportional assist ventilation plus for weaning from mechanical ventilation in critically ill patients
Background: Pressure support ventilation (PSV) is a widely used weaning mode that provides varying amount of support with changing lung characteristics. Proportional-assist ventilation plus (PAV+) is a new mode that automatically adjusts to changes in the respiratory system. Aim: This study compared PSV and PAV+ for weaning from mechanical ventilation. Methods: This was a prospective, randomised, control study enrolling 23 adult patients, mechanically ventilated for at least 48 h after passing SBT criteria and a PSV trial of 30 min. They were randomised to receive either PAV+ (Group 1) or PSV (Group 2). A washout time of 30 min was given for patients in either of the group in order to nullify the effect of the previous PSV mode. Two arterial blood gas samples were taken, during the assessment of SBT readiness, and after 60 min on the randomised weaning mode. Clinical signs of respiratory distress and objective weaning criteria were noted. Success and duration of weaning, rapid shallow breathing index (RSBI), rapid shallow breathing index rate (RSBI rate), haemodynamic and respiratory parameters were noted. Results: 13 patients were randomised to PAV+ group; 10 patients to PSV group. Demographic data were similar in both groups. RSBI, RSBI rate, arterial blood gas analysis, peak and mean inspiratory pressure were not different in either group. The average length of ICU stay, duration to wean and days to extubate were almost similar in both groups. Conclusion: Both PAV+ mode and PSV can be used with equal efficiency in patients ready for weaning.
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