改变麻醉机上的默认呼吸机设置可提高肺保护性通气措施的依从性。

Changing Default Ventilator Settings on Anesthesia Machines Improves Adherence to Lung-Protective Ventilation Measures.

机构信息

From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.

Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.

出版信息

Anesth Analg. 2018 Apr;126(4):1219-1222. doi: 10.1213/ANE.0000000000002575.

DOI:10.1213/ANE.0000000000002575

PMID:29200060

Abstract

Perioperative lung-protective ventilation (LPV) can reduce perioperative pulmonary morbidity. We hypothesized that modifying default anesthesia machine ventilator settings would increase the use of intraoperative LPV. Default tidal volume settings on our anesthesia machines were decreased from 600 to 400 mL, and default positive end-expiratory pressure was increased from 0 to 5 cm H2O. This modification increased mean positive end-expiratory pressure from 3.1 to 5.0 cm H2O and decreased mean tidal volume from 8.2 to 6.7 mL/kg predicted body weight. Notably, increased adherence to LPV from 1.6% to 23.0% occurred quickly with the rate of increase more than doubling from 1.8% to 3.9% per year.

摘要

围手术期肺保护性通气（LPV）可降低围手术期肺部发病率。我们假设，修改默认的麻醉机通气设置将增加术中 LPV 的使用。我们的麻醉机上的默认潮气量设置从 600 毫升减少到 400 毫升，默认呼气末正压从 0 增加到 5 厘米 H2O。这种修改使平均呼气末正压从 3.1 增加到 5.0 厘米 H2O，平均潮气量从预测体重的 8.2 减少到 6.7 毫升/公斤。值得注意的是，LPV 的依从性从 1.6%迅速增加到 23.0%，每年的增长率从 1.8%增加到 3.9%，增加了一倍多。