Branson R D
Department of Surgery, University of Cincinnati, Cincinnati, Ohio 45267-0558, USA.
Semin Respir Crit Care Med. 2000;21(3):203-9. doi: 10.1055/s-2000-9847.
Mechanical ventilators have become more sophisticated with the advent of microprocessor control. Advances in monitoring have also improved our ability to harmonize patient-ventilator interaction. The next obvious step in this technologic progression is to turn over some decision making to the ventilator. In the jargon of today, we are "closing the loop.'' Ventilators have used closed-loop control for simple tasks for the last decade. Newer closed-loop processes include modes that increase or decrease support based on a single-monitored variable. An example is the automated control of pressure support to maintain a deired tidal volume. More sophisticated closed-loop techniques, such as proportional assist ventilation and adaptive support ventilation, not only monitor multiple input variables but also use closed-loop control of several variables. This article reviews the closed-loop ventilation modes currently available to clinicians.
随着微处理器控制技术的出现，机械通气机变得更加精密复杂。监测技术的进步也提高了我们协调患者与通气机相互作用的能力。在这一技术发展进程中，下一个明显的步骤是将一些决策工作交给通气机。用当今的行话来说，我们正在“闭环控制”。在过去十年中，通气机已将闭环控制用于简单任务。更新的闭环程序包括基于单一监测变量增加或减少支持的模式。一个例子是压力支持的自动控制，以维持所需的潮气量。更复杂的闭环技术，如比例辅助通气和适应性支持通气，不仅监测多个输入变量，还对多个变量进行闭环控制。本文综述了目前临床医生可用的闭环通气模式。
