Simonds A K, Parker R A, Branthwaite M A
Department of Thoracic Medicine, Brompton Hospital, London, UK.
Respiration. 1989;55(3):136-43. doi: 10.1159/000195724.
The effects of intermittent positive-pressure hyperinflation on lung volumes, arterial blood gas tensions and respiratory muscle performance have been assessed in 10 patients with severe scoliosis (vital capacity 22-43% predicted). Hyperinflation was carried out 2-3 times a day for 5 min aiming to double the spontaneous tidal volume with each delivered breath. A volume-preset, time-cycled device was used in 6 patients and a pressure-cycled, patient-triggered machine in 4 cases. Progressive reduction in lung volume was reversed by the volume-preset device which increased the mean vital capacity from 29 to 33% predicted after 3 months (p less than 0.05) with improvement maintained after 9 months. This machine offered a significant advantage over the pressure-cycled device which at maximum or near maximum inflation pressures produced less hyperinflation and had no beneficial effect on lung volumes. The improvement in vital capacity was correlated with the degree of hyperinflation (r = 0.65; p less than 0.05). The effect of hyperinflation on arterial blood gas tensions was transient and not accompanied by an increase in accessible alveolar volume.
对10例严重脊柱侧弯患者（肺活量为预测值的22%-43%）评估了间歇性正压通气对肺容量、动脉血气张力和呼吸肌功能的影响。通气每天进行2-3次，每次5分钟，目的是使每次输送的呼吸量使自主潮气量增加一倍。6例患者使用了容积预设、时间切换设备，4例使用了压力切换、患者触发设备。容积预设设备可逆转肺容量的逐渐减少，3个月后平均肺活量从预测值的29%增加到33%（p<0.05），9个月后仍保持改善。该设备比压力切换设备具有显著优势，后者在最大或接近最大充气压力时产生的通气量较少，对肺容量没有有益影响。肺活量的改善与通气程度相关（r = 0.65；p<0.05）。通气对动脉血气张力的影响是短暂的，且未伴有可及肺泡容积的增加。
