Chen Yen-Huey, Yeh Ming-Chu, Hu Han-Chung, Lee Chung-Shu, Li Li-Fu, Chen Ning-Hung, Huang Chung-Chi, Kao Kuo-Chin
Department of Respiratory Care, Chang Gung University College of Medicine, 259 Wenhua 1st Road, Guishan District, Taoyuan City 33302, Taiwan.
Department of Respiratory Therapy, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Fu-Shing Street, Guishan District, Taoyuan City 33305, Taiwan.
Can Respir J. 2016;2016:5624315. doi: 10.1155/2016/5624315. Epub 2016 Mar 29.
Common complications in PMV include changes in the airway clearance mechanism, pulmonary function, and respiratory muscle strength, as well as chest radiological changes such as atelectasis. Lung expansion therapy which includes IPPB and PEEP prevents and treats pulmonary atelectasis and improves lung compliance. Our study presented that patients with PMV have improvements in lung volume and oxygenation after receiving IPPB therapy. The combination of IPPB and PEEP therapy also results in increase in respiratory muscle strength. The application of IPPB facilitates the homogeneous gas distribution in the lung and results in recruitment of collapsed alveoli. PEEP therapy may reduce risk of respiratory muscle fatigue by preventing premature airway collapse during expiration. The physiologic effects of IPPB and PEEP may result in enhancement of pulmonary function and thus increase the possibility of successful weaning from mechanical ventilator during weaning process. For patients with PMV who were under the risk of atelectasis, the application of IPPB may be considered as a supplement therapy for the enhancement of weaning outcome during their stay in the hospital.
有创正压通气（PMV）的常见并发症包括气道清除机制、肺功能和呼吸肌力量的改变，以及诸如肺不张等胸部放射学改变。包括间歇性正压通气（IPPB）和呼气末正压（PEEP）的肺扩张治疗可预防和治疗肺不张，并改善肺顺应性。我们的研究表明，接受IPPB治疗后，有创正压通气患者的肺容量和氧合得到改善。IPPB和PEEP治疗的联合应用还可导致呼吸肌力量增加。IPPB的应用有助于肺内气体均匀分布，并导致萎陷肺泡复张。PEEP治疗可通过防止呼气期间气道过早塌陷来降低呼吸肌疲劳风险。IPPB和PEEP的生理效应可能导致肺功能增强，从而增加在撤机过程中成功脱离机械通气的可能性。对于有肺不张风险的有创正压通气患者，IPPB的应用可被视为一种补充治疗，以提高其住院期间的撤机效果。
