Herschman Z, Sonnenklar N, Blumberg G, Klapholz A, Oropello J
Mount Sinai School of Medicine, New York.
Respir Care. 1991 Oct;36(10):1119-22.
We compared flow-by ventilation (FB) via the Puritan-Bennett 7200a ventilator with T-piece ventilation (TP) during weaning from mechanical ventilation (MV).
We placed 22 consecutive postsurgical patients being weaned from MV on FB at base flows of 10 L/min and 20 L/min and then on TP. Blood pressure, pulse rate, respiratory rate, blood gases, tidal volume, and peak inspiratory flow were measured after at least 20 min in each mode. Statistical analysis of clinical status used a three-level, one-way analysis of variance with technique as a within-subjects factor. Setup costs of the three ventilatory modes were evaluated using relative value units for labor plus actual costs of added equipment and supplies.
Although there was a statistically significant difference in PaCO2 among the ventilatory modes, this was not clinically important. No other differences were found. Each FB mode cost $2.55 to set up, whereas TP cost $11.90.
FB and TP were clinically equivalent. However, the alarm and monitoring capabilities during FB are useful and may be worth the one-time cost ($1,000) of adding the optional flow-by software to the 7200a ventilator.
我们比较了在机械通气（MV）撤机过程中，通过Puritan-Bennett 7200a呼吸机进行的持续气流通气（FB）与T形管通气（TP）。
我们将22例连续的术后撤机患者先以10 L/min和20 L/min的基础气流进行FB通气，然后进行TP通气。在每种模式下至少20分钟后测量血压、脉搏率、呼吸频率、血气、潮气量和吸气峰流速。临床状态的统计分析采用三级单向方差分析，将技术作为受试者内因素。使用劳动相对价值单位加上额外设备和用品的实际成本来评估三种通气模式的设置成本。
尽管通气模式之间的动脉血二氧化碳分压（PaCO2）存在统计学显著差异，但这在临床上并不重要。未发现其他差异。每种FB模式的设置成本为2.55美元，而TP为11.90美元。
FB和TP在临床上等效。然而，FB期间的报警和监测功能很有用，可能值得为7200a呼吸机添加可选的持续气流软件而支付的一次性成本（1000美元）。
