Branson Richard D, Johannigman Jay A, Campbell Robert S, Davis Kenneth
Department of Surgery, Division of Trauma/Critical Care, University of Cincinnati, Cincinnati, Ohio 45267-0558, USA.
Respir Care. 2002 Apr;47(4):427-51; discussion 451-3.
Closed-loop mechanical ventilation encompasses a plethora of techniques, ranging from the very simple to the relatively complex. In the simplest form, closed-loop ventilation is the control of one output variable of the mechanical ventilator based on the measurement of an input variable. An example would be pressure support ventilation, in which flow (output) is constantly changing to maintain pressure (input) constant throughout inspiration. More complex forms of closed-loop ventilation involve measurement of multiple inputs (eg, compliance, oxygen saturation, respiratory rate) to control multiple outputs (eg, ventilator frequency, airway pressure, tidal volume). The latter type of control more closely mimics the ventilatory control and response of human physiology. This review discusses both currently available closed-loop ventilation techniques and those only available outside the United States, along with some cutting-edge techniques that have only limited use. The operation, theoretical advantages, and limitations of each technique are reviewed. When available, the literature supporting or refuting each technique will be reviewed, but, unfortunately, little has been published on certain techniques.
闭环机械通气包含大量技术，从非常简单的到相对复杂的都有。以最简单的形式来说，闭环通气是基于对一个输入变量的测量来控制机械通气机的一个输出变量。一个例子是压力支持通气，在这种通气方式中，流量（输出）在整个吸气过程中不断变化以维持压力（输入）恒定。更复杂的闭环通气形式涉及对多个输入（如顺应性、氧饱和度、呼吸频率）的测量，以控制多个输出（如通气机频率、气道压力、潮气量）。后一种控制类型更接近地模拟了人体生理学的通气控制和反应。本综述讨论了当前可用的闭环通气技术以及那些仅在美国境外可用的技术，还有一些使用有限的前沿技术。对每种技术的操作、理论优势和局限性进行了综述。如果有相关文献，会对支持或反驳每种技术的文献进行综述，但遗憾的是，关于某些技术的发表文献很少。
