de Vries Heder, Jonkman Annemijn, Shi Zhong-Hua, Spoelstra-de Man Angélique, Heunks Leo
Department of Intensive Care Medicine, Amsterdam Cardiovascular Sciences, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Ann Transl Med. 2018 Oct;6(19):387. doi: 10.21037/atm.2018.05.53.
Recent studies have shown both beneficial and detrimental effects of patient breathing effort in mechanical ventilation. Quantification of breathing effort may allow the clinician to titrate ventilator support to physiological levels of respiratory muscle activity. In this review we will describe the physiological background and methodological issues of the most frequently used methods to quantify breathing effort, including esophageal pressure measurement, the work of breathing, the pressure-time-product, electromyography and ultrasound. We will also discuss the level of breathing effort that may be considered optimal during mechanical ventilation at different stages of critical illness.
最近的研究表明，在机械通气中患者的呼吸努力既有有益影响，也有不利影响。对呼吸努力进行量化可能会使临床医生将呼吸机支持调整至呼吸肌活动的生理水平。在本综述中，我们将描述用于量化呼吸努力的最常用方法的生理背景和方法学问题，包括食管压力测量、呼吸功、压力-时间乘积、肌电图和超声检查。我们还将讨论在危重病不同阶段的机械通气期间，可被视为最佳的呼吸努力水平。
