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[麻醉与重症监护呼吸机:COVID-19患者的差异与可用性]

[Anesthesia and intensive care ventilators: differences and usability in COVID-19 patients].

作者信息

Notz Q, Herrmann J, Stumpner J, Schmid B, Schlesinger T, Kredel M, Kranke P, Meybohm P, Lotz C

机构信息

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

出版信息

Anaesthesist. 2020 May;69(5):316-322. doi: 10.1007/s00101-020-00781-y.

Abstract

The current coronavirus disease 2019 (Covid-19) pandemia is a highly dynamic situation characterized by therapeutic and logistic uncertainties. Depending on the effectiveness of social distancing, a shortage of intensive care respirators must be expected. Concomitantly, many physicians and nursing staff are unaware of the capabilities of alternative types of ventilators, hence being unsure if they can be used in intensive care patients. Intensive care respirators were specifically developed for the use in patients with pathological lung mechanics. Nevertheless, modern anesthesia machines offer similar technical capabilities including a number of different modes. However, conceptual differences must be accounted for, requiring close monitoring and the presence of trained personnel. Modern transport ventilators are mainly for bridging purposes as they can only be used with 100% oxygen in contaminated surroundings. Unconventional methods, such as "ventilator-splitting", which have recently received increasing attention on social media, cannot be recommended. This review intends to provide an overview of the conceptual and technical differences of different types of mechanical ventilators.

摘要

当前的2019冠状病毒病(Covid-19)大流行是一种极具动态性的情况,其特点是治疗和后勤方面存在不确定性。根据社交距离措施的有效性,预计会出现重症监护呼吸机短缺的情况。与此同时,许多医生和护理人员并不了解其他类型呼吸机的功能,因此不确定它们是否可用于重症监护患者。重症监护呼吸机是专门为患有病理性肺力学问题的患者设计的。然而,现代麻醉机也具备类似的技术能力,包括多种不同模式。不过,必须考虑到概念上的差异,这需要密切监测并配备经过培训的人员。现代转运呼吸机主要用于过渡目的,因为在受污染环境中它们只能使用100%的氧气。诸如“呼吸机拆分”等非传统方法,最近在社交媒体上受到越来越多关注,但不建议采用。本综述旨在概述不同类型机械呼吸机在概念和技术上的差异。

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