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[机械通气撤机过程中呼吸肌功能的监测]

[Monitoring of the respiratory muscle function during weaning from mechanical ventilation].

作者信息

Pickerodt Philipp A, Francis Roland C E, Weber-Carstens Steffen

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 Oct;48(10):634-9. doi: 10.1055/s-0033-1358628. Epub 2013 Nov 5.

Abstract

Early weaning and discontinuation of mechanical ventilation can help prevent respiratory muscle dysfunction in critically ill patients. Prolonged mechanical ventilation and failure to use adequate strategies to discontinue mechanical ventilation can even enhance and perpetuate respiratory muscle dysfunction. On the other hand, premature attempts to extubate may result in re-intubation due to respiratory failure and are associated with poor outcomes and high mortality rates of up to 30-50%. Therefore, accurate monitoring of the respiratory muscle function is a valuable tool for the clinician at the bedside to assess to optimal weaning strategy and, ideally, would predict either weaning failure or success. In this review, we briefly summarize the available techniques, measurements and equipment required for the monitoring of respiratory muscle function in the intensive care unit.

摘要

早期撤机和停止机械通气有助于预防重症患者的呼吸肌功能障碍。长时间机械通气以及未能采用适当策略停止机械通气甚至会加重并使呼吸肌功能障碍持续存在。另一方面,过早尝试拔管可能因呼吸衰竭导致重新插管,并与不良预后及高达30%-50%的高死亡率相关。因此,准确监测呼吸肌功能是临床医生床边评估最佳撤机策略的重要工具,理想情况下,还能预测撤机失败或成功。在本综述中,我们简要总结了重症监护病房监测呼吸肌功能所需的现有技术、测量方法和设备。

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