Lucangelo Umberto, Bernabé Francesca, Blanch Lluís
Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Cattinara Hospital, Trieste, Italy.
Respir Care. 2005 Jan;50(1):55-65; discussion 65-7.
The aim of this article is to identify and interpret the data provided by modern ventilators that provide the greatest clinical help in evaluating respiratory mechanics during mechanical ventilation. In intensive care, respiratory mechanics can be assessed in dynamic conditions (no flow-interruption) or static conditions (occlusion techniques) to record compliance and resistance and to monitor pressure, flow, and volume. Real-time visualization of the pressure curve is crucial for monitoring during volume-controlled ventilation, in which pressure is the dependent variable. Analysis of the pressure curve has little clinical utility during pressure-controlled ventilation, in which the dependent variable is the flow waveform, which varies according to changes in the mechanics of the respiratory system. Pressure-volume loops and flow-volume loops provide useful information on the dynamic trends of the respiratory system compliance and resistance, respectively. Modern ventilators provide complete monitoring of respiratory system mechanics, which is our guideline for optimizing ventilatory support and avoiding complications associated with mechanical ventilation.
本文的目的是识别和解读现代呼吸机所提供的数据,这些数据在评估机械通气期间的呼吸力学方面具有最大的临床帮助。在重症监护中,可以在动态条件(无气流中断)或静态条件(阻塞技术)下评估呼吸力学,以记录顺应性和阻力,并监测压力、流量和容积。压力曲线的实时可视化对于容量控制通气期间的监测至关重要,在容量控制通气中压力是因变量。在压力控制通气期间,压力曲线分析的临床实用性较小,在压力控制通气中因变量是流量波形,其会根据呼吸系统力学的变化而变化。压力-容积环和流量-容积环分别提供有关呼吸系统顺应性和阻力动态趋势的有用信息。现代呼吸机可对呼吸系统力学进行全面监测,这是我们优化通气支持并避免与机械通气相关并发症的指导原则。