Laier-Groeneveld G, Hüttemann U, Criée C P
Krankenhaus an der Lieth, Pneumologische Klinik, Bovenden-Lenglern/Universität Göttingen.
Med Klin (Munich). 1991 May 15;86(5):229-33.
Noninvasive intermittent ventilation (NIV) is performed as controlled mechanical ventilation to put the inspiratory muscles at rest and to normalize the arterial blood gases. As access to the airways an individual nasal mask was used. weaning from tracheostoma ventilation had failed after 74 days on average. 27 patients were treated, when hypercapnic ventilatory failure had not improved within three weeks of conventional therapy (eight patients with kyphoscoliosis, 15 COPD, six neuromuscular disease, three sequelas of tbc). During NIV, there was an increase in inspiratory muscle force, indicated by an increase in maximal inspiratory mouth occlusion from 42 to 58 cm H2O (p less than 0.01). With this increase in muscular force, spontaneous minute volume increased, resulting in an increase in pO2 from 56 to 70 mm Hg (p less than 0.001) and a decrease in pCO2 from 53 to 43 mm Hg (p less than 0.001), as well as an increase in exercise capacity. NIV therefore can improve hypercapnic ventilatory failure effectively. It can be used early in chronic respiratory failure, during weaning from mechanical ventilation, allowing the early and costsaving discharge from the ICU.
无创间歇通气（NIV）作为控制性机械通气，使吸气肌得到休息并使动脉血气正常化。气道接入采用单个鼻面罩。平均74天后气管造口通气撤机失败。对27例患者进行了治疗，这些患者在常规治疗三周内高碳酸血症性通气衰竭未改善（8例脊柱侧弯患者、15例慢性阻塞性肺疾病患者、6例神经肌肉疾病患者、3例肺结核后遗症患者）。在无创间歇通气期间，吸气肌力增加，最大吸气时口腔闭合压从42厘米水柱增加到58厘米水柱表明了这一点（p<0.01）。随着肌力增加，自主分钟通气量增加，导致动脉血氧分压从56毫米汞柱增加到70毫米汞柱（p<0.001），动脉血二氧化碳分压从53毫米汞柱降至43毫米汞柱（p<0.001），同时运动能力增强。因此，无创间歇通气可有效改善高碳酸血症性通气衰竭。它可在慢性呼吸衰竭早期、机械通气撤机期间使用，使患者能早期从重症监护病房出院并节省费用。
