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持续气道正压通气(CPAP)——该设备名副其实吗?

[Continuous positive airway pressure (CPAP)--does the equipment live up to its name?].

作者信息

Christensen E F, Nørregaard O F, Anker-Møller E, Spangsberg N L, Petersen K D, Schønemann N K

机构信息

Arhus Kommunehospital, anaestesiologisk afdeling.

出版信息

Ugeskr Laeger. 1992 May 25;154(22):1568-71.

PMID:1631985
Abstract

The purpose of this study was to evaluate the in- and expiratory pressures achieved by the use of different continuous positive airway pressure (CPAP) delivery systems. The study was performed on ten healthy adults breathing spontaneously with: 1) "simple CPAP", consisting of a fresh gas flow around 40 l/min and reservoir balloons of 2, 6 and 10 l and expiration against a water column, 2) a high-flow system CR60 CPAP, designed for home treatment and 3) another high-flow system Down's CPAP. Both high-flow systems used a venturi device (Downs Flow Generator, Vital Signs) giving flows around 90 and 170 l/min in our set-up, and the same PEEP valves (Vital signs) were used. All systems were tested with expiratory pressures set at 5, 10 and 20 cm H2O. Individual responses were found, but in general the simple CPAP with a 10 l latex balloon reservoir gave optimal CPAP. The high-flow systems were not found to provide better CPAP, however, CR60 CPAP was found also to be optimal with 5 and 10 cm H2O. Down's CPAP provided 3-5 cm higher expiratory pressure than the intended CPAP level. We recommend measurement of the pressure during the CPAP treatment to ensure that the intended CPAP is achieved.

摘要

本研究的目的是评估使用不同的持续气道正压通气(CPAP)输送系统所达到的吸气和呼气压力。该研究对10名自主呼吸的健康成年人进行,使用以下设备:1)“简易CPAP”,由约40升/分钟的新鲜气流、2升、6升和10升的储气囊以及对着水柱呼气组成;2)专为家庭治疗设计的高流量系统CR60 CPAP;3)另一种高流量系统唐氏CPAP。在我们的设置中,两种高流量系统均使用文丘里装置(Downs Flow Generator,Vital Signs),产生约90和170升/分钟的气流,并使用相同的呼气末正压(PEEP)阀(Vital signs)。所有系统均在呼气压力设置为5、10和20厘米水柱的情况下进行测试。发现了个体差异,但总体而言,带有10升乳胶气囊储液器的简易CPAP能提供最佳的CPAP。未发现高流量系统能提供更好的CPAP,然而,CR60 CPAP在5厘米水柱和10厘米水柱时也被发现是最佳的。唐氏CPAP提供的呼气压力比预期的CPAP水平高3 - 5厘米水柱。我们建议在CPAP治疗期间测量压力,以确保达到预期水平的CPAP。

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