Duwoos H, Lévi-Valensi P, Nouveau J, Guyonnaud C D, Muir J F
Rev Fr Mal Respir. 1979 Jul-Aug;7(4):416-8.
Effectiveness and haemodynamic tolerance of M.A.V. in conscious patients with a severe respiratory insufficiency is mainly due to the proper adaptation to ventilator with low frequency and adequate V.T. Thus M.A.V. is an eventual complement to directed ventilation exercises which in addition reduce the "rebound" of hypoxia and hypercapnia after a M.A.V. session. A proper adaptation ensures haemodynamic tolerance. Expiratory time should be sufficient in such obstructive patients. A post inspiratory pause can improve V.C.O2. Nevertheless, it should not shorten inspiratory time to less than one second and for each patient the best ventilatory profile should be properly established taking into account blood gases, circulatory, expired CO2 and clinical monitoring.
M.A.V. 对重度呼吸功能不全清醒患者的有效性及血流动力学耐受性主要归因于对低频及适当潮气量通气机的恰当适应。因此,M.A.V. 是定向通气训练的一种最终补充,此外还能减少 M.A.V. 疗程后缺氧和高碳酸血症的“反弹”。恰当的适应可确保血流动力学耐受性。在这类阻塞性患者中,呼气时间应足够。吸气后暂停可改善 V.C.O2。然而,不应将吸气时间缩短至少于一秒,对于每位患者,应综合考虑血气、循环、呼出二氧化碳及临床监测情况,恰当确立最佳通气模式。