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放射治疗中用于呼吸固定的高频振荡通气

High frequency percussive ventilation for respiratory immobilization in radiotherapy.

作者信息

Sala Ina M, Nair Girish B, Maurer Beverly, Guerrero Thomas M

机构信息

William Beaumont Hospital, Department of Radiation Oncology, Royal Oak, MI, United States.

Wayne State University, Karmanos Cancer Center, Detroit, MI, United States.

出版信息

Tech Innov Patient Support Radiat Oncol. 2018 Dec 14;9:8-12. doi: 10.1016/j.tipsro.2018.11.001. eCollection 2019 Mar.

Abstract

High frequency percussive ventilation (HFPV) employs high frequency low tidal volumes (100-400 bursts/min) to provide respiration in awake patients while simultaneously reducing respiratory motion. The purpose of this study is to evaluate HFPV as a technique for respiratory motion immobilization in radiotherapy. In this study fifteen healthy volunteers (age 30-75 y) underwent HFPV using three different oral interfaces. We evaluated each HFPV oral interface device for compliance, ease of use, comfort, geometric interference, minimal chest wall motion, duty cycle and prolonged percussive time. Their chest wall motion was monitored using an external respiratory motion laser system. The percussive ventilations were delivered via an air driven pneumatic system. All volunteers were monitored for PO and tc-CO with a pulse oximeter and CO Monitoring System. A total of N = 62 percussive sessions were analyzed from the external respiratory motion laser system. Chest-wall motion was well tolerated and drastically reduced using HFPV in each volunteer evaluated. As a result, we believe HFPV may provide thoracic immobilization during radiotherapy, particularly for SBRT and pencil beam scanning proton therapy.

摘要

高频振荡通气(HFPV)采用高频低潮气量(100 - 400次/分钟)为清醒患者提供呼吸支持,同时减少呼吸运动。本研究的目的是评估HFPV作为放射治疗中呼吸运动固定技术的效果。在本研究中,15名健康志愿者(年龄30 - 75岁)使用三种不同的口腔接口进行了HFPV。我们评估了每种HFPV口腔接口设备的顺应性、易用性、舒适度、几何干扰、最小胸壁运动、占空比和延长的振荡时间。使用外部呼吸运动激光系统监测他们的胸壁运动。振荡通气通过气动系统输送。所有志愿者均使用脉搏血氧仪和二氧化碳监测系统监测动脉血氧分压(PO)和潮气末二氧化碳分压(tc - CO)。从外部呼吸运动激光系统共分析了N = 62次振荡通气疗程。在评估的每位志愿者中,HFPV对胸壁运动的耐受性良好且显著降低。因此,我们认为HFPV可能在放射治疗期间提供胸部固定,特别是对于立体定向体部放射治疗(SBRT)和笔形束扫描质子治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85f5/7033809/38abb021a31c/gr1.jpg

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