Closed-loop flow-control of the expiration for assisted spontaneous breathing - FLEX-ASB

当患者无法产生所需的呼吸功时，机械通气是挽救生命的关键疗法。尽管机械通气是一种主要的救生疗法，但由于呼吸系统中的非生理压力关系，机械通气本身与肺部的潜在损害相关。因此，研究机械通气的主要任务是开发肺保护性机械通气的选择。我们小组的一个主要进展是用于受控机械通气的流量控制呼气（FLEX）。在动物实验中，可以证明FLEX诱导的减速和线性呼气流量是肺保护性的。在健康受试者中的研究表明，FLEX增加的呼吸不适小于呼气末正压（PEEP），并且在受控术中机械通气期间，FLEX引起的肺内通气分布比常规机械通气更均匀。（例如在重症监护治疗期间）接受辅助自主呼吸形式的机械通气。因此，本项目的目的是开发一种可在辅助自主呼吸过程中应用的FLEX-ASB系统，并证明其在辅助自主呼吸过程中对健康肺和限制性和阻塞性疾病肺的潜在肺保护作用。

Mechanical ventilation is the life-saving key-therapy whenever a patient is not able to generate the required work of breathing. Although it is a major life-saving therapy, mechanical ventilation is per se associated with potential harm of the lungs due to the non-physiological pressure relationships in the respiratory system. The main task for research regarding mechanical ventilation is therefore the development of options for lung-protective mechanical ventilation.A major development from our group is the flow-controlled expiration (FLEX) for the controlled mechanical ventilation. In animal experiments could demonstrate that the FLEX-induced decelerated and linearized expiratory flow is lung protective. Studies in healthy test persons showed that FLEX increases the discomfort of breathing less than positive end-expiratory pressure (PEEP) and in patients during controlled intraoperative mechanical ventilation FLEX caused a more homogeneous intrapulmonal ventilation distribution than conventional mechanical ventilation.Most mechanically ventilated patients suffering from lung disease (e.g. during intensive care therapy) receive mechanical ventilation in a form of assisted spontaneous breathing. The aim of this project is therefore to develop a FLEX-ASB system that can be applied during assisted spontaneous breathing and to demonstrate its potentially lung protective effects in healthy lungs and in lungs with restrictive and obstructive diseases during assisted spontaneous breathing.