Gueret G, Rossignol B, Ferrec G, Arvieux C-C, Bourgain J-L
Département d'anesthésie-réanimation chirurgicale, centre hospitalier universitaire la Cavale-Blanche, rue Tanguy-Prigent, 29609 Brest, France.
Ann Fr Anesth Reanim. 2006 Oct;25(10):1030-3. doi: 10.1016/j.annfar.2006.06.005. Epub 2006 Sep 26.
To test a high-frequency jet ventilator, the Mistral (Acutronic Laboratory) on a lung model.
The jet ventilator Mistral was tested with two connectors (7 and 20 ml) and four catheters. Pressure and flow measurements were performed by varying the driving pressure (1 to 3 bars), the I/T ratio (0.25, 0.35, 0.45) and the frequency (1 to 5 Hz). Recorded data were: the volume delivered by the ventilator, the pressure measured in the connecting line between the ventilator and the injector and the difference between the end expiratory pressure measured by the ventilator through the injector and the tracheal pressure.
An increase in driving pressure induced a proportional increase in minute volume whatever the injection catheter used. After insufflation, when a Seldicath catheter was used, the pressure decrease was the slowest and the time constant the longest. Increase in frequency or I/T ratio, particularly beyond 0.35, was associated with an increase of the end expiratory pressure measured by the respirator. The gradient of pressure measured by the respirator and by an external sensor was lower with the 7 ml connector whatever the catheter used, and was larger with the Seldicath catheter.
The use of a low volume connector should be preferred, because it allows the measurement of the end expiratory pressure for a larger range of driving pressure, expiratory time and catheters. The performances of the Seldicath catheter are below those of the other catheters studied.
在肺模型上测试一种高频喷射呼吸机——米斯特拉尔(阿库特ronic实验室)。
使用两种连接器(7毫升和20毫升)和四种导管对米斯特拉尔喷射呼吸机进行测试。通过改变驱动压力(1至3巴)、吸呼比(I/T比,0.25、0.35、0.45)和频率(1至5赫兹)来进行压力和流量测量。记录的数据包括:呼吸机输送的容积、在呼吸机与注射器之间的连接管路中测得的压力,以及呼吸机通过注射器测得的呼气末压力与气管压力之间的差值。
无论使用何种注射导管,驱动压力的增加都会导致分钟通气量成比例增加。充气后,当使用塞尔迪卡导管时,压力下降最慢,时间常数最长。频率或I/T比的增加,尤其是超过0.35时,与呼吸机测得的呼气末压力增加有关。无论使用何种导管,使用7毫升连接器时,呼吸机和外部传感器测得的压力梯度都较低,而使用塞尔迪卡导管时则较大。
应优先使用小容积连接器,因为它能在更大范围的驱动压力、呼气时间和导管条件下测量呼气末压力。塞尔迪卡导管的性能低于所研究的其他导管。