热湿交换器对机械通气慢性阻塞性肺疾病患者动态肺过度充气的影响。
Effects of the heat-moisture exchangers on dynamic hyperinflation of mechanically ventilated COPD patients.
作者信息
Conti G, De Blasi R A, Rocco M, Pelaia P, Antonelli M, Bufi M, Mattia C, Gasparetto A
机构信息
Istituto di Anestesiologia e Rianimazione, I.C.U., University La Sapienza, Rome, Italy.
出版信息
Intensive Care Med. 1990;16(7):441-3. doi: 10.1007/BF01711222.
In recent years the use of devices called Heat and Moisture Exchangers (HME) has become widespread as gas conditioners for ICU patients requiring mechanical ventilation. As an important variation of the resistive properties of the HME, related to flow and duration of use, has recently been pointed out during "in vitro" studies, the use of these devices in COPD patients could increase the levels of auto PEEP and dynamic hyperinflation. In this study we have compared the levels of auto PEEP and difference in functional residual capacity (delta FRC) in a group of COPD patients, requiring controlled mechanical ventilation (CMV), at basal conditions and after the insertion into the circuit of three HMEs (Dar Hygrobac, Pall Ultipor, Engstrom Edith) at random: the results obtained excluded a significant increase of auto PEEP and delta (FRC) both with "new" HMEs and after 12 h of continuous use.
近年来，一种名为热湿交换器（HME）的设备作为需要机械通气的重症监护病房（ICU）患者的气体调节器已得到广泛应用。由于最近在“体外”研究中指出，与流量和使用时长相关的HME电阻特性存在一个重要变化，因此在慢性阻塞性肺疾病（COPD）患者中使用这些设备可能会增加内源性呼气末正压（auto PEEP）水平和动态肺过度充气。在本研究中，我们比较了一组需要控制机械通气（CMV）的COPD患者在基础状态下以及随机在回路中插入三种热湿交换器（Dar Hygrobac、Pall Ultipor、Engstrom Edith）后内源性呼气末正压水平和功能残气量差异（delta FRC）：所获得的结果排除了使用“新型”热湿交换器以及连续使用12小时后内源性呼气末正压和delta（FRC）的显著增加。
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