Emrath Elizabeth
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Medical University of South Carolina, 125 Doughty Street, MSC 917, Charleston, SC 29425 USA.
Curr Pediatr Rep. 2021;9(1):11-19. doi: 10.1007/s40124-020-00235-4. Epub 2021 Jan 5.
Knowledge of ventilator waveforms is important for clinicians working with children requiring mechanical ventilation. This review covers the basics of how to interpret and use data from ventilator waveforms in the pediatric intensive care unit.
Patient-ventilator asynchrony (PVA) is a common finding in pediatric patients and observed in approximately one-third of ventilator breaths. PVA is associated with worse outcomes including increased length of mechanical ventilation, increased length of stay, and increased mortality. Identification of PVA is possible with a thorough knowledge of ventilator waveforms.
Ventilator waveforms are graphical descriptions of how a breath is delivered to a patient. These include three scalars (flow versus time, volume versus time, and pressure versus time) and two loops (pressure-volume and flow-volume). Thorough understanding of both scalars and loops, and their characteristic appearances, is essential to being able to evaluate a patient's respiratory mechanics and interaction with the ventilator.
对于从事小儿机械通气工作的临床医生而言,了解呼吸机波形至关重要。本综述涵盖了如何解读和使用小儿重症监护病房中呼吸机波形数据的基础知识。
患者-呼吸机不同步(PVA)在小儿患者中很常见,约三分之一的呼吸机呼吸中可观察到。PVA与更差的预后相关,包括机械通气时间延长、住院时间延长和死亡率增加。通过全面了解呼吸机波形可以识别PVA。
呼吸机波形是对向患者输送呼吸的方式的图形描述。这些包括三个标量(流量与时间、容积与时间、压力与时间)和两个环(压力-容积环和流量-容积环)。全面理解标量和环及其特征表现,对于评估患者的呼吸力学以及与呼吸机的相互作用至关重要。