East T D, Wortelboer P J, van Ark E, Bloem F H, Peng L, Pace N L, Crapo R O, Drews D, Clemmer T P
Department of Anesthesiology, University of Utah Medical Center, Salt Lake City 84132.
Crit Care Med. 1990 Jan;18(1):84-91. doi: 10.1097/00003246-199001000-00018.
A new sulfur hexafluoride (SF6) washout functional residual capacity (FRC) measurement system has been developed which will work with any mode of mechanical ventilation, as well as with spontaneous respiration. This system was evaluated in three different human studies. In the first two studies, the accuracy of the system was compared with He dilution and body plethysmography in 12 spontaneously breathing normal volunteers and in 12 spontaneously breathing chronic obstructive pulmonary disease (COPD) patients. In the third study, the reproducibility and efficacy of using the system in the ICU was tested in 12 adult respiratory distress syndrome (ARDS) patients who were mechanically ventilated with PEEP. In the normal volunteers, there was no significant difference between the three measurement techniques. In the COPD group, there was an overall significant difference between measurement techniques (F[2,28] = 17.18, p less than .0001) and the rank of the magnitude of the FRC measurements from lowest to highest was SF6 washout, He dilution, and body plethysmography. There was a significant difference in accuracy between the COPD and normal volunteer groups (F[2,28] = 12.24, p less than .0002). There were a total of 1,227 FRC measurements made on the 12 ARDS patients. The number of FRC measurements per patient was 102 +/- 13 (SEM). The "stable" periods were 14 +/- 2 h long and ranged from 60 min to 63.5 h. The reproducibility for all 12 patients was 188 +/- 17 ml or 11.7 +/- 0.7%. This automated SF6 washout system should make routine FRC measurements in patients who are being mechanically ventilated simple and easy to do.(ABSTRACT TRUNCATED AT 250 WORDS)
一种新的六氟化硫(SF6)洗脱功能残气量(FRC)测量系统已被开发出来,它可与任何机械通气模式以及自主呼吸配合使用。该系统在三项不同的人体研究中进行了评估。在前两项研究中,在12名自主呼吸的正常志愿者和12名自主呼吸的慢性阻塞性肺疾病(COPD)患者中,将该系统的准确性与氦稀释法和体容积描记法进行了比较。在第三项研究中,在12名接受呼气末正压通气(PEEP)机械通气的成人呼吸窘迫综合征(ARDS)患者中测试了该系统在重症监护病房(ICU)使用的可重复性和有效性。在正常志愿者中,三种测量技术之间没有显著差异。在COPD组中,测量技术之间总体存在显著差异(F[2,28]=17.18,p<0.0001),FRC测量值从低到高的大小顺序为SF6洗脱法、氦稀释法和体容积描记法。COPD组和正常志愿者组在准确性上存在显著差异(F[2,28]=12.24,p<0.0002)。对12名ARDS患者共进行了1227次FRC测量。每名患者的FRC测量次数为102±13(标准误)。“稳定”期为14±2小时,范围从60分钟到63.5小时。所有12名患者的可重复性为188±17毫升或11.7±0.7%。这种自动化的SF6洗脱系统应能使对接受机械通气患者的常规FRC测量变得简单易行。(摘要截断于250字)