食管和膈压波动作为吸气努力的指标。
Esophageal and transdiaphragmatic pressure swings as indices of inspiratory effort.
机构信息
Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Greece.
Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Greece.
出版信息
Respir Physiol Neurobiol. 2021 Feb;284:103561. doi: 10.1016/j.resp.2020.103561. Epub 2020 Oct 6.
AIM
To describe the correlation between the inspiratory esophageal and transdiaphragmatic pressure swings (ΔPes and ΔPdi), easily measured indices of inspiratory effort, with the gold-standard, the transdiaphragmatic pressure time product (PTP/min), and assess the accuracy of swing pressures in predicting very high or low effort.
METHOD
Retrospective analysis of data from patients enrolled in four previous studies. ROC curves of ΔPes and ΔPdi values for specific PTP/min thresholds (50, 150, 200 cmHO × sec/min) were constructed, and the diagnostic accuracy of different thresholds of swing values were computed.
RESULTS
A threshold of inspiratory ΔP<7cmHO can be used to identify most patients with low effort, as lower ΔP thresholds have low sensitivity. Thresholds of inspiratory ΔP>14-18cmHO can be used to identify patients with very high inspiratory effort (PTP/min> 200 cmHO × sec/min).
CONCLUSIONS
The results of this study can help clinicians better select and interpret thresholds of ΔP to evaluate inspiratory effort.
目的
描述吸气食管压和跨膈压变化（ΔPes 和 ΔPdi）与金标准——膈压时间乘积（PTP/min）之间的相关性，吸气努力的简便测量指标，并评估摆动压力预测高或低努力的准确性。
方法
对四项先前研究中纳入的患者数据进行回顾性分析。为特定的 PTP/min 阈值（50、150、200 cmHO×sec/min）构建了ΔPes 和 ΔPdi 值的 ROC 曲线，并计算了不同摆动值阈值的诊断准确性。
结果
吸气ΔP<7cmHO 的阈值可用于识别大多数低努力患者，因为较低的ΔP 阈值敏感性较低。吸气ΔP>14-18cmHO 的阈值可用于识别具有非常高吸气努力（PTP/min>200 cmHO×sec/min）的患者。
结论
本研究结果可以帮助临床医生更好地选择和解释ΔP 来评估吸气努力。
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