Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure.
Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure.
复制标题
急性呼吸衰竭机械通气期间呼吸系统力学的无创测定。
DOI：
--
复制
发表时间：
1985
期刊：
影响因子：
--
通讯作者：
J. Milic‐Emili
中科院分区：
文献类型：
--
作者：
S. Gottfried;A. Rossi;B. Higgs;P. Calverley;L. Zocchi;C. Bozic;J. Milic‐Emili
在10例急性呼吸衰竭患者中，采用最近描述的中断器技术测定呼吸系统力学（J apple Physiol 1984; 56:681-690）。在一系列短暂的呼气中断中测量流量、体积和气管压力。所有患者均观察到中断期间气管压力的平台，表明呼吸肌松弛以及肺泡和气管压力之间的平衡。测量中断后气管压力、相应体积和前流量的平台，可以确定整个呼吸系统的被动弹性和流动阻力特性。一般情况下，容积-压力关系在检查的过期容积上呈线性关系，并不一定通过原点，这表明机械通气时呼气末肺容积偏离呼吸系统的平衡位置。弹性，或该关系的逆斜率，平均为16.88 +/- 1.90 (SE) cmH2O x1（-1）。呼吸系统压力-流量呈曲线关系；流速为1.0 X s-1时，平均电阻为19.74 +/- 2.08 (SE) cmH2O × 1（-1） × s。6例患者压力-流量关系为上凹。在其余患者中，呈上凸状，特别是在终末时。这与呼气中断后特征性的“超极大”流量瞬间有关，表明存在动态气道压迫和呼气流量限制。总之，中断技术可以使用简单的无创设备详细检查机械通气患者全呼吸系统的被动弹性和流动阻力特性。（摘要删节250字）
In 10 acutely ill patients mechanically ventilated for management of acute respiratory failure, respiratory system mechanics were determined with the interrupter technique as described recently (J Appl Physiol 1984; 56:681-690). Flow, volume, and tracheal pressure were measured throughout a series of brief expiratory interruptions. A plateau in tracheal pressure during interruption was observed in all patients, indicating respiratory muscle relaxation as well as equilibration between alveolar and tracheal pressure. Measurement of the plateau in postinterruption tracheal pressure, corresponding volume, and preceding flow enabled determination of the passive elastic and flow-resistive properties of the total respiratory system. In general, the volume-pressure relationship was linear over the expired volume examined and did not necessarily pass through the origin, indicating deviation of the end-expiratory lung volume during mechanical ventilation from the equilibrium position of the respiratory system. Elastance, or inverse slope of this relationship, averaged 16.88 +/- 1.90 (SE) cmH2O X 1(-1). The pressure-flow relationship of the respiratory system was curvilinear; resistance averaged 19.74 +/- 2.08 (SE) cmH2O X 1(-1) X s at a flow rate of 1.0 1 X s-1. In 6 patients the pressure-flow relationship was concave upward. An upward convexity, particularly towards end expiration, was present in the remaining patients. This was associated with characteristic "supramaximal" flow transients after expiratory interruptions, indicating the presence of dynamic airway compression and expiratory flow limitation. In conclusion, the interrupter technique enabled detailed examination of the passive elastic and flow-resistive properties of the total respiratory system in mechanically ventilated patients using simple, noninvasive equipment.(ABSTRACT TRUNCATED AT 250 WORDS)
慢性阻塞性肺疾病的动态过度通货膨胀和呼吸机依赖。
DOI：
10.1164/arrd.1982.126.6.991
发表时间：
1982
期刊：
The American review of respiratory disease
影响因子：
--
作者：
Kimball,WR;Leith,DE;Robins,AG
通讯作者：
Robins,AG