Advanced cuff pressure control ventilation (ACPCV); a bench study of a new concept of mechanical ventilation
Advanced cuff pressure control ventilation (ACPCV); a bench study of a new concept of mechanical ventilation
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高级袖带压力控制通气（ACPCV）；
DOI：
10.1080/03091902.2021.1900437
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Yuji Fujino
中科院分区：
文献类型：
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作者：
Ryota Higeno;Akinori Uchiyama;Yusuke Enokidani;Yuji Fujino
先进袖带压力控制通气（ACPCV）的概念是可以控制气管插管（ETT）袖带体积并允许通过声带呼出气体。 APCCV 的潜在优点是减少死腔、减少呼气气道阻力和保留声带功能。我们开发了 APCCV 系统并在实验室研究中研究了其性能。根据气道压力和气管压力，通过四个步骤调节 ETT 套囊体积。在几种自主呼吸努力速率下检查了两种通气设置。将ACPCV的强加呼气阻力（RE）、强加呼气呼吸功（WOB）和自动PEEP与连续强制通气（CMV）进行比较。ACPCV的RE（2.6±0.5cm H2O/l/s）显着低于CMV（11.6±1.6cm H2O/l/s） (p< 0.001)。 APCCV 的呼气 WOB (0.25±0.02J/l) 显着低于 CMV (0.54±0.10J/l) (p<0.001)。 APCCV 的自动 PEEP (-0.6±0.2cm H2O) 显着低于 CMV (1.1±0.7cm H2O) (p<0.001)。 APCCV 通过与机械通气同步控制 ETT 袖带容量，可以显着降低 RE 和呼气 WOB。
The concept of advanced cuff pressure control ventilation (ACPCV) is that the endotracheal tube (ETT) cuff volume could be controlled and allowed to exhale the gas through the vocal cords. The potential advantages of ACPCV are reduction of dead space, reduction of expiratory airway resistance, and preservation of vocal cord function. We developed the ACPCV system and investigated its performance in bench studies. The ETT cuff volume was regulated via four steps, depending on airway pressure and tracheal pressure. Two ventilatory settings were examined under several rates of spontaneous breathing efforts. Imposed expiratory resistance (RE), imposed expiratory work of breathing (WOB), and auto-PEEP of ACPCV were compared with continuous mandatory ventilation (CMV).REof ACPCV (2.6 ± 0.5 cm H2O/l/s) was significantly lower than that of CMV (11.6 ± 1.6 cm H2O/l/s) (p< 0.001). Expiratory WOB of ACPCV (0.25 ± 0.02 J/l) was significantly lower than that of CMV (0.54 ± 0.10 J/l) (p< 0.001). Auto-PEEP of ACPCV (−0.6 ± 0.2 cm H2O) was significantly lower than that of CMV (1.1 ± 0.7 cm H2O) (p< 0.001). ACPCV can significantly reduceREand expiratory WOB by controlling the ETT cuff volume in synchronisation with mechanical ventilation.