Patroniti N, Saini M, Zanella A, Weismann D, Isgrò S, Bellani G, Foti G, Pesenti A
Department of Experimental Medicine, University of Milano-Bicocca, Ospedale San Gerardo Nuovo dei Tintori, via Donizetti 106, 20052 Monza, Milan, Italy.
Intensive Care Med. 2008 Dec;34(12):2235-40. doi: 10.1007/s00134-008-1218-1. Epub 2008 Jul 23.
Assessing limits of agreement with helium dilution and repeatability of a new system (lung funcution, LUFU) that measures end-expiratory lung volume (EELV) in mechanically ventilated patients using the O(2) washin (EELV(Win)) and washout (EELV(Wout)) technique. LUFU consists of an Evita 4 ventilator, a side-stream oxygen analyzer, and a dedicated PC software.
Prospective human study in a general ICU of a University hospital.
Thirty-six mechanically ventilated patients.
We obtained 36 couples of both EELV(Win) and EELV(Wout) measurements in each patient (5 with healthy lungs, 9 with ALI, 22 with ARDS). Measurements were obtained with patients ventilated either by assisted (ASB, 16 measurements) or controlled (CMV, 20 measurements) ventilation. In 19 of 20 cases in CMV, we obtained helium dilution measurements (EELV(He)).
Bias for agreement with EELV(He) was -16 +/- 156 and 8 +/- 161 ml, respectively, for EELV(Win) and EELV(Wout). Bias for agreement between EELV(Win) and EELV(Wout) was 28 +/- 78 and 23 +/- 168 ml, respectively, for CMV and ASB. During CMV bias for repeatability were 8 +/- 92 and 23 +/- 165 ml, respectively, for EELV(Win) and EELV(Wout). During ASB bias for repeatability were 32 +/- 160 and -15 +/- 147 ml, respectively, for EELV(Win) and EELV(Wout).
The LUFU method showed good agreement with helium, and good repeatability during partial and controlled mechanical ventilation. The technique is simple and safe.
评估一种新系统（肺功能，LUFU）与氦稀释法的一致性限度以及重复性，该系统采用氧气冲洗（EELV(Win)）和冲洗（EELV(Wout)）技术测量机械通气患者的呼气末肺容积（EELV）。LUFU由一台Evita 4呼吸机、一台旁流式氧分析仪和专用的计算机软件组成。
在一所大学医院的综合重症监护病房进行的前瞻性人体研究。
36例机械通气患者。
我们在每位患者身上获取了36对EELV(Win)和EELV(Wout)测量值（5例肺健康，9例急性肺损伤，22例急性呼吸窘迫综合征）。测量是在患者接受辅助通气（ASB，16次测量）或控制通气（CMV，20次测量）时进行的。在CMV的20例病例中的19例中，我们获得了氦稀释测量值（EELV(He)）。
与EELV(He)的一致性偏差分别为，EELV(Win)为-16±156 ml，EELV(Wout)为8±161 ml。CMV和ASB时，EELV(Win)与EELV(Wout)之间的一致性偏差分别为28±78 ml和23±168 ml。CMV期间，EELV(Win)和EELV(Wout)的重复性偏差分别为8±92 ml和23±165 ml。ASB期间，EELV(Win)和EELV(Wout)的重复性偏差分别为32±160 ml和-15±147 ml。
LUFU方法与氦稀释法显示出良好的一致性，并且在部分通气和控制机械通气期间具有良好的重复性。该技术简单且安全。
