Westermann Erik J A, Verweij-van den Oudenrijn Laura P, Gaytant Michael A, Kampelmacher Mike J
Universitair Medisch Centrum Utrecht, divisie voor Inwendige Geneeskunde en Dermatologie, Centrum voor Thuisbeademing, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2011;155(18):A3371.
Lung volume recruitment can improve peak cough flows and respiratory compliance in patients who either do or do not require mechanical ventilation. There are several lung volume recruitment techniques: air stacking, glossopharyngeal breathing and mechanical insufflation-exsufflation with cough assist devices. The principle of lung volume recruitment is based on the insufflation of air in the lungs after maximal inspiration. In air stacking, a manual resuscitation bag is used for insufflation. Glossopharyngeal breathing requires the use of oropharyngeal and laryngeal muscles by the patient. The mechanical cough assist device exsufflates the air after insufflation. These techniques may prevent pulmonary complications, hospital admission and tracheotomy in patients with a reduced ability to cough, a proclivity towards atelectasis and recurrent airway infections. The combination of long-term mechanical ventilation with lung volume recruitment has led to further improvement in the prognosis of chronic respiratory failure. More patients may potentially benefit from lung volume recruitment than only those being converted from short-term to long-term mechanical ventilation.
肺容量复张可改善需要或不需要机械通气患者的咳嗽峰值流量和呼吸顺应性。有几种肺容量复张技术：气叠式呼吸、舌咽呼吸以及使用咳嗽辅助装置进行机械吹气-抽气。肺容量复张的原理基于在最大吸气后向肺内吹气。在气叠式呼吸中，使用手动复苏袋进行吹气。舌咽呼吸要求患者使用口咽和喉部肌肉。机械咳嗽辅助装置在吹气后抽气。这些技术可预防咳嗽能力下降、易发生肺不张和反复气道感染的患者出现肺部并发症、住院和气管切开。长期机械通气与肺容量复张相结合已进一步改善了慢性呼吸衰竭的预后。可能受益于肺容量复张的患者比仅从短期机械通气转为长期机械通气的患者更多。
