Cuirass ventilation in childhood neuromuscular disease.
Cuirass ventilation in childhood neuromuscular disease.
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儿童神经肌肉疾病的胸甲通气。
DOI：
10.1016/s0022-3476(79)80588-0
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发表时间：
1979
期刊：
影响因子：
--
通讯作者：
N. Lewiston
中科院分区：
文献类型：
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作者：
J. O'leary;R. King;M. Leblanc;R. Moss;M. Liebhaber;N. Lewiston
材料和方法如果患者的肺部相对正常，意味着肺顺应性正常，并满足以下一个或多个治疗标准(表)：(1)PaO~小于50；(2)PAR~>55；(3)肌肉无力，足以导致休息时呼吸困难；(4)睡眠时缺乏呼吸动力；(5)无法摆脱正压通气。商业硫化铁壳是从Monaghan公司(科罗拉多州丹佛)获得的。如果患者的胸部构型接近正常，腋中至髂骨的长度大于20厘米，柄至耻骨的长度大于25厘米，则可以使用这些方法。如果病人比这个小或有明显的胸部畸形，可以用塑料布从胸部的石膏凹痕制作一个胸甲。炮弹由170-C型莫纳汉呼吸器提供动力。最初的设置是产生-20厘米的H20吸气压力和+4厘米的呼气压力。通过在舒适的范围内改变呼吸频率和吸气压力来实现所需的分钟通气量。最初的目标是将PaCO2从预防水平降低约15Torr。作为..。患者学会了与药物、动脉血同步地增加呼吸努力
MATERIALS AND METHODSPatients were considered candidates for cuirass ventilation if they had relatively normal lungs, implying normal pulmonary compliance, and met one or more of the following therapeutic criteria (Table):(1) Pao~ less than 50 tort;(2) Par~ greater than 55 tort;(3) muscle weakness sufficient to produce dyspnea at rest;(4) lack of ventilatory drive when asleep; and (5) inability to wean from positive pressure ventilation. Commercial cuirass shells were obtained from the Monaghan Company (Denver, Colo.). These could be used with minor alterations if the patient had nearly normal chest configuration, had a midaxillary to iliac crest measurement greater than 20 cm, and a manubrium to pubis measurement greater than 25 cm. If the patient was smaller than this or had marked thoracic deformity, a cuirass shell was fabricated from a plaster impression of the chest with plastic sheeting. The shells were powered with a Model 170-C Monaghan Respirator. Initial settings were made to produce an inspiratory pressure of-20 cm of H20 and an expiratory pressure of+ 4 cm. The desired minute ventilation was achieved by altering respiratory rate and inspiratory pressure within comfortable limits. The initial goal was to decrease the Paco2 by approximately 15 torr from preventilation values. As the. patient learned to add his respiratory efforts in synchrony with the medicine, arterial blood