Montecchia F, Guerrisi M, Canichella A
Medical Physics section, Department of Biopathology and Imaging, Tor Vergata University, Rome, Italy.
Med Eng Phys. 2007 Mar;29(2):259-76. doi: 10.1016/j.medengphy.2006.03.006. Epub 2006 May 6.
The present paper describes the functional features of an advanced lung ventilation system (ALVS) properly designed for the optimization of conventional dual-controlled ventilation (DCV), i.e. with pressure-controlled ventilation with ensured tidal or minute volume. Considering the particular clinical conditions of patients treated with controlled ventilation the analysis and synthesis of ALVS control have been performed assuming a linear respiratory mechanics. Moreover, new airways pressure waveforms with more physiological shape can be tested on simulators of respiratory system in order to evaluate their clinical application. This is obtained through the implementation of a compensation procedure making the desired airways pressure waveform independent on patient airways resistance and lung compliance variations along with a complete real-time monitoring of respiratory system parameters leading the ventilator setting. The experimental results obtained with a lung simulator agree with the theoretical ones and show that ALVS performance is useful for the research activity aiming at the improvement of both diagnostic evaluation and therapeutic outcome relative to mechanical ventilation treatments.
本文描述了一种先进的肺通气系统（ALVS）的功能特性，该系统经过合理设计，用于优化传统的双控制通气（DCV），即具有确保潮气量或分钟通气量的压力控制通气。考虑到接受控制通气治疗患者的特殊临床情况，在假设线性呼吸力学的情况下对ALVS控制进行了分析和综合。此外，可以在呼吸系统模拟器上测试具有更生理形状的新气道压力波形，以评估其临床应用。这是通过实施一种补偿程序来实现的，该程序使所需的气道压力波形与患者气道阻力和肺顺应性变化无关，同时对引导呼吸机设置的呼吸系统参数进行完整的实时监测。使用肺模拟器获得的实验结果与理论结果一致，并表明ALVS的性能对于旨在改善机械通气治疗的诊断评估和治疗效果的研究活动是有用的。
