Peters S G, Viggiano R W
Critical Care Service, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1988 Dec;63(12):1208-13. doi: 10.1016/s0025-6196(12)65407-x.
Recently, interest in the use of mechanical ventilation outside the hospital setting has been increasing. Patients with various types of chronic respiratory failure may benefit from this approach. Evaluation for long-term mechanical ventilation necessitates assessment of the underlying disease process, the goals of the medical team, and the needs of the patient and family. Externally applied negative-pressure devices can provide adequate ventilation for many patients, particularly those with neuromuscular diseases. Positive-pressure ventilation by means of a tracheostomy provides greater control of the airway, allows adjustment of tidal volume and minute ventilation, and may be delivered by portable equipment. Ongoing care and support services in the home must be provided. A variety of mechanical devices and new techniques of ventilator support have made home mechanical ventilation a realistic option for long-term care.
最近，医院外使用机械通气的关注度一直在增加。患有各种类型慢性呼吸衰竭的患者可能会从这种方法中受益。对长期机械通气的评估需要对潜在疾病过程、医疗团队的目标以及患者和家属的需求进行评估。外部应用的负压设备可为许多患者提供足够的通气，特别是那些患有神经肌肉疾病的患者。通过气管造口术进行的正压通气能更好地控制气道，允许调整潮气量和分钟通气量，并且可以通过便携式设备进行。必须在家中提供持续的护理和支持服务。各种机械设备和新的通气支持技术使家庭机械通气成为长期护理的一个现实选择。
