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在使用水加热加湿器和热交换器过滤器模型进行机械通气的神经科患者的呼吸力学

Respiratory mechanics of neurological patients undergoing mechanical ventilation under water heated humidifier and a heat exchanger filter model.

作者信息

Siqueira Tiago Branco, Costa Juliana Cristina Gomes de Freitas, Tavares Isnar Campos, Torres Priscilla Muniz, Andrade Maria do Amparo, França Eduardo Ériko Tenório de, Galindo Filho Valdecir Castor, Andrade Flávio Maciel Dias

机构信息

Faculdade Redentor, Recife, PE, Brasil.

Faculdade Integrada do Recife, Recife, PE, Brasil.

出版信息

Rev Bras Ter Intensiva. 2010 Sep;22(3):264-9.

Abstract

OBJECTIVES

In mechanically ventilated patients, humidifier devices are used to heat and moisturize the inspired gas. Heating and humidifying inspired gas may prevent complications associated with the respiratory mucosa dryness such as mucus plugging and endotracheal tube occlusion. Two devices have been commonly used to this, either heated humidifier or the heat moisture exchange filter. This study aimed to compare the effects of the heated humidifier and a model of heat moisture exchange filter on respiratory mechanics in mechanically ventilated neurological patients.

METHODS

This was a randomized crossover trial, involving 31 neurological patients under mechanical ventilation randomly assigned to the humidification devices. Expired tidal volume, peak inspiratory flow, peak expiratory flow, static compliance, dynamic compliance and respiratory system resistance were evaluated. Statistical analysis used the Kolmogorov-Smirnov test and Student's t test for paired samples, in which P values < 0.05 were considered significant.

RESULTS

The heat moisture exchanger filter decreased expired tidal volume, peak inspiratory flow, peak expiratory flow (p < 0.001) and dynamic compliance (p = 0.002), and increased respiratory system resistance (p < 0.001).

CONCLUSION

In the studied population, the use of a heat moisture exchange filter model leaded to several changes on respiratory mechanics parameters.

摘要

目的

在机械通气患者中,使用加湿器装置对吸入气体进行加热和加湿。加热和加湿吸入气体可预防与呼吸道黏膜干燥相关的并发症,如黏液堵塞和气管插管阻塞。通常使用两种装置来实现这一点,即加热加湿器或热湿交换过滤器。本研究旨在比较加热加湿器和一种热湿交换过滤器模型对机械通气神经科患者呼吸力学的影响。

方法

这是一项随机交叉试验,纳入31例接受机械通气的神经科患者,将其随机分配至加湿装置组。评估呼出潮气量、吸气峰流速、呼气峰流速、静态顺应性、动态顺应性和呼吸系统阻力。统计分析采用Kolmogorov-Smirnov检验和配对样本的Student's t检验,其中P值<0.05被认为具有统计学意义。

结果

热湿交换过滤器使呼出潮气量、吸气峰流速、呼气峰流速降低(p<0.001),动态顺应性降低(p=0.002),呼吸系统阻力增加(p<0.001)。

结论

在所研究的人群中,使用热湿交换过滤器模型导致呼吸力学参数出现若干变化。

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