Driving pressure and arterial carbon dioxide tension during high-frequency jet ventilation in postoperative patients.
Driving pressure and arterial carbon dioxide tension during high-frequency jet ventilation in postoperative patients.
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DOI：
10.1097/00003246-198801000-00012
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发表时间：
1988
影响因子：
8.8
通讯作者：
R. Bayly;A. Sladen;I. L. Tyler;R. F. Echegaray;M. Klain;K. Guntupalli
中科院分区：
文献类型：
--
作者：
R. Bayly;A. Sladen;I. L. Tyler;R. F. Echegaray;M. Klain;K. Guntupalli
为了在常规机械通气期间实现正常碳酸，最初基于体重确定呼吸机设置。在高频喷射通气（HFJV）期间消除CO2的最佳呼吸机设置尚未明确定义。最近的一项研究表明，当每公斤体重的潮气量（VT）保持在一个狭窄的、明确定义的范围内时，HFJV将获得优卡比。在同一研究中，“台架试验”证明VT与喷射呼吸机驱动压力（DP）成正比。我们研究的目的是确认推荐的VT/kg以获得优卡比，并确定在实验室中观察到的VT和DP之间的关系在临床上是否正确。我们研究了14例入住ICU进行术后支持的患者。我们确定了整个组的DP和VT/kg之间的良好相关性（r = 0.811，p小于0.001），以及大多数个体患者的DP或VT/kg和PaCO 2之间的良好负相关性;然而，由于射流通气效率的患者间差异很大，整个组的DP或VT/kg和PaCO 2之间的负相关性较差。我们的结论是，没有通用的公式来设置喷射呼吸机DP或VT/kg，以影响人体的正常碳酸。
To achieve normocarbia during conventional mechanical ventilation, ventilator settings are determined initially on the basis of body weight. The best ventilator settings for CO2 elimination during high-frequency jet ventilation (HFJV) have not been so clearly defined. A recent study has suggested that eucarbia will be obtained with HFJV when tidal volume (VT) per kg of body weight is kept within a narrow, well-defined range. In the same study, a "bench test" demonstrated that VT was directly proportional to the jet ventilator driving pressure (DP). The goal of our study was to confirm this recommended VT/kg to obtain eucarbia and to determine whether the relation observed between VT and DP in the laboratory was true clinically. We studied 14 patients admitted to the ICU for postoperative support. We determined a good correlation between DP and VT/kg (r = .811, p less than .001) for the group as a whole and a good inverse correlation between DP or VT/kg and PaCO2 for most individual patients; however, there was a poor inverse correlation between DP or VT/kg and PaCO2 for the group as a whole, due to wide patient-to-patient variation in the efficiency of jet ventilation. We conclude that there is no universal formula for setting jet ventilator DP or VT/kg to affect normocarbia in humans.