Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada,
J Anesth. 2015 Feb;29(1):152-5. doi: 10.1007/s00540-014-1872-0. Epub 2014 Jul 4.
There is no strong evidence to support ventilatory management for critical limitation of expiratory flow, such as bronchospasm during anesthesia or an acute exacerbation of severe asthma and chronic obstructive pulmonary disease (COPD). Animal models cannot be used to develop reproducible experimental models for conducting mechanical ventilation strategy research relating to these etiologies due to the resulting respiratory and hemodynamic instabilities. Therefore, we developed a device model by modifying a positive end-expiratory pressure (PEEP) valve that can simulate the characteristics of airway bronchoconstriction (i.e., limited peak expiratory flow and a prolonged expiratory phase). These characteristics were found to improve upon narrowing the expiratory port. We believe that this device model will facilitate future mechanical ventilation experiments.
目前尚无强有力的证据支持对呼气流量受限进行通气管理，例如麻醉期间的支气管痉挛或严重哮喘和慢性阻塞性肺疾病（COPD）的急性加重。由于呼吸和血流动力学不稳定，动物模型不能用于开发与这些病因相关的机械通气策略研究的可重现实验模型。因此，我们通过修改呼气末正压（PEEP）阀来开发了一种设备模型，该模型可以模拟气道支气管痉挛的特征（即，峰值呼气流量受限和呼气阶段延长）。发现这些特征可以通过缩小呼气口来改善。我们相信这种设备模型将有助于未来的机械通气实验。
