Cavaliere F, Conti G, Costa R, Spinazzola G, Proietti R, Sciuto A, Masieri S
Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Largo Francesco Vito, 1, Rome, Italy.
Acta Anaesthesiol Scand. 2008 Jan;52(1):52-6. doi: 10.1111/j.1399-6576.2007.01474.x. Epub 2007 Nov 8.
We measured noise intensity and perceived noisiness during continuous positive airway pressure (CPAP) performed with two interfaces (face-mask, helmet) and four delivery systems.
Eight healthy volunteers received CPAP in random order with: two systems provided with a flow generator using the Venturi effect and a mechanical expiratory valve (A: Venturi, Starmed; B: Whisperflow-2, Caradyne Ltd); one 'free-flow' system provided with high flow O(2) and air flowmeters, an inspiratory gas reservoir, and a water valve (C: CF800, Drägerwerk, AG); and a standard mechanical ventilator (Servoventilator 300, Siemens-Elema). Systems A, B, and C were tested with a face-mask and a helmet at a CPAP value of 10 cm H(2)O; the mechanical ventilator was only tested with the face mask. Noise intensity was measured with a sound-level meter. After each test, participants scored noisiness on a visual analog scale (VAS).
The noise levels measured ranged from 57+/-11 dBA (mechanical ventilator plus mask) to 93+/-1 and 94+/-2 dBA (systems A and B plus helmet) and were significantly affected by CPAP systems (A and B noisier than C and D) and interfaces (helmet CPAP noisier than mask CPAP). Subjective evaluation showed that systems A and B plus helmet were perceived as noisier than system C plus mask or helmet.
Maximum noise levels observed in this study may potentially cause patient discomfort. Less noisy CPAP systems (not using Venturi effect) and interfaces (facial mask better than helmet) should be preferred, particularly for long or nocturnal treatments.
我们测量了使用两种接口（面罩、头盔）和四种输送系统进行持续气道正压通气（CPAP）时的噪声强度和主观噪声感受。
八名健康志愿者以随机顺序接受CPAP，使用以下设备：两种配备利用文丘里效应的流量发生器和机械呼气阀的系统（A：文丘里，Starmed；B：Whisperflow - 2，Caradyne有限公司）；一种配备高流量氧气和空气流量计、吸气储气罐和水阀的“自由流”系统（C：CF800，德尔格公司）；以及一台标准机械通气机（Servoventilator 300，西门子 - 埃莱玛）。系统A、B和C在CPAP值为10 cm H₂O时使用面罩和头盔进行测试；机械通气机仅使用面罩进行测试。用声级计测量噪声强度。每次测试后，参与者在视觉模拟量表（VAS）上对噪声程度进行评分。
测量的噪声水平范围为57±11 dBA（机械通气机加面罩）至93±1和94±2 dBA（系统A和B加头盔），并且受到CPAP系统（A和B比C和D更吵）和接口（头盔CPAP比面罩CPAP更吵）的显著影响。主观评估表明，系统A和B加头盔被认为比系统C加面罩或头盔更吵。
本研究中观察到的最大噪声水平可能会使患者感到不适。应优先选择噪声较小的CPAP系统（不使用文丘里效应）和接口（面罩优于头盔），特别是对于长时间或夜间治疗。
