Proportional assist ventilation. Results of an initial clinical trial.
Proportional assist ventilation. Results of an initial clinical trial.
复制标题
比例辅助通气。
DOI：
10.1164/ajrccm/145.1.121
复制
发表时间：
1992
期刊：
影响因子：
--
通讯作者：
H. Cramp
中科院分区：
文献类型：
--
作者：
M. Younes;A. Puddy;D. Roberts;R. Light;A. Quesada;K. Taylor;L. Oppenheimer;H. Cramp
在四名剧烈运动的正常受试者和五名从各种疾病中恢复的依赖呼吸机的患者中测试了比例辅助通气 (PAV) 的反应。该装置由与电机耦合的滚动密封活塞组成，该电机产生与吸入流量和吸入体积成比例的压力，并调整增益，使气道压力 (Paw) 和患者产生的瞬时压力 (Pmus) 之间的比例约为 1:1（即机器将患者的努力放大 2 倍）。根据食管压力判断，正常受试者对 PAV 的反应是减少自己的努力，因此通气和呼吸模式的变化相当小（VE：PAV 期间 64.8 +/- 3.6 对比 56.0 +/- 4.3，p 小于 0.01；VT：2.39 +/- 0.24 对比 2.02 +/- 0.17，p 小于 0.05；f： 27.5 +/- 1.9 与 28.0 +/- 2.2，NS)。患者的弹性范围为 20 至 35 cm H2O cm/L，阻力范围为 5 至 10 cm H2O/L/s，最大吸气压力范围为 -16 至 -65 cm H2O。在同步间歇机械通气 (SIMV) 期间观察一段时间后，患者改用 PAV 并维持 1 至 3 小时。没有患者因任何监测变量的不适或恶化而必须更换 SIMV。 PAV 期间气道峰值压力小于 IMV 呼吸观察值的一半（16.6 +/- 2.4 与 35.4 +/- 3.4 cm H2O，p 小于 0.001）。（摘要截断为 250 字）
The response to proportional assist ventilation (PAV) was tested in four normal subjects during heavy exercise and in five ventilator-dependent patients recovering from assorted medical disorders. The apparatus consisted of a rolling-seal piston coupled to a motor that generated pressure in proportion to inspired flow and inspired volume, with the gains adjusted such that the proportionality between airway pressure (Paw) and instantaneous patient-generated pressure (Pmus) was approximately 1:1 (i.e., machine-amplified patient effort by a factor of 2). Normal subjects responded to PAV by decreasing their own effort, as judged from esophageal pressure, such that the changes in ventilation and breathing pattern were rather small (VE: 64.8 +/- 3.6 during PAV versus 56.0 +/- 4.3, p less than 0.01; VT: 2.39 +/- 0.24 versus 2.02 +/- 0.17, p less than 0.05; f: 27.5 +/- 1.9 versus 28.0 +/- 2.2, NS). In patients, elastance ranged from 20 to 35 cm H2O cm/L, resistance ranged from 5 to 10 cm H2O/L/s, and maximal inspiratory pressure ranged from -16 to -65 cm H2O. After a period of observation during synchronized intermittent mechanical ventilation (SIMV) the patient was switched to PAV and maintained on it for 1 to 3 h. No patient had to be replaced on SIMV because of discomfort or deterioration in any of the monitored variables. During PAV peak airway pressure was less than half the value observed with the IMV breaths (16.6 +/- 2.4 versus 35.4 +/- 3.4 cm H2O, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)