Breuer Thomas, Bruells Christian S, Rossaint Rolf, Steffen Henning, Disselhorst-Klug Catherine, Czaplik Michael, Zoremba Norbert
Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, D-52074, Aachen, Germany.
Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany.
J Cardiothorac Surg. 2017 Nov 10;12(1):96. doi: 10.1186/s13019-017-0658-5.
Early detection of respiratory overload is crucial to mechanically ventilated patients, especially during phases of spontaneous breathing. Although a diversity of methods and indices has been established, there is no highly specific approach to predict respiratory failure. This study aimed to evaluate acceleration sensors in abdominal and thoracic wall positions to detect alterations in breathing excursions in a setting of gradual increasing airway resistance.
Twenty-nine healthy volunteers were committed to a standardized protocol of a two-minutes step-down spontaneous breathing on a 5 mm, 4 mm and then 3 mm orally placed endotracheal tube. Accelerator sensors in thoracic and abdominal wall position monitored breathing excursions. 15 participants passed the breathing protocol ("completed" group), 14 individuals cancelled the protocol due to subjective intolerance to the increasing airway resistance ("abandoned" group).
Gradual increased respiratory workload led to a significant decrease of acceleration in abdominal wall position in the "abandoned" group compared to the "completed" group (p < 0.001), while these gradual accelerating changes were not observed in thoracic wall position (p = 0.484). Thoracic acceleration sensors did not detect any time- and group-specific changes (p = 0.746).
The abdominal wall position of the acceleration sensors may be a non-invasive, economical and practical approach to detect early breathing alterations prior to respiratory failure.
EK 309-15; by the Ethics Committee of the Faculty of Medicine, RWTH Aachen, Aachen, Germany. Retrospectively registered 28th of December 2015.
早期发现呼吸负荷过重对机械通气患者至关重要，尤其是在自主呼吸阶段。尽管已经建立了多种方法和指标，但尚无高度特异性的方法来预测呼吸衰竭。本研究旨在评估置于腹壁和胸壁位置的加速度传感器，以检测在气道阻力逐渐增加的情况下呼吸偏移的变化。
29名健康志愿者按照标准化方案，在经口放置5毫米、4毫米然后3毫米的气管插管上进行两分钟的递减自主呼吸。置于胸壁和腹壁位置的加速度传感器监测呼吸偏移。15名参与者完成了呼吸方案（“完成”组），14名个体因主观上无法耐受气道阻力增加而取消了方案（“放弃”组）。
与“完成”组相比，“放弃”组中逐渐增加的呼吸负荷导致腹壁位置的加速度显著降低（p < 0.001），而在胸壁位置未观察到这些逐渐加速的变化（p = 0.484）。胸壁加速度传感器未检测到任何时间和组特异性变化（p = 0.746）。
加速度传感器置于腹壁位置可能是一种检测呼吸衰竭前早期呼吸变化的非侵入性、经济且实用的方法。
EK 309 - 15；由德国亚琛工业大学医学院伦理委员会注册。于2015年12月28日进行回顾性注册。
