应用心电导联评估负压通气对慢性阻塞性肺疾病患者短期血流动力学的影响：一项初步研究

A pilot study of short-term hemodynamic effects of negative pressure ventilation in chronic obstructive pulmonary disease assessed using electrical cardiometry.

机构信息

Department of Respiratory, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.

School of Physical Therapy, Graduate Institute of Rehabilitation Sciences, Chang Gung University, Taoyuan, Taiwan.

出版信息

Ann Noninvasive Electrocardiol. 2021 Sep;26(5):e12843. doi: 10.1111/anec.12843. Epub 2021 Mar 17.

DOI:10.1111/anec.12843

PMID:33733510

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8411802/

Abstract

BACKGROUND

Pulmonary rehabilitation combined with negative pressure ventilation (NPV) demonstrated benefits in patients with chronic obstructive pulmonary disease (COPD). The effect of NPV remains unknown. This study aims to clarify the short-term response of the hemodynamic outcome of NPV in patients with COPD undergoing pulmonary rehabilitation program by electrical cardiometry.

METHODS

This is an observational retrospective study of COPD patients who had been treated in a pulmonary rehabilitation unit with NPV between January 2018 and December 2019 that were enrolled to analyze the hemodynamic outcomes.

RESULTS

Thirty patients with COPD that were undergoing a pulmonary rehabilitation program and were regularly receiving NPV were enrolled. Cardiac output (p < .001) and heart rate (p < .001) showed a significant decrease after NPV. Stroke volume did not demonstrate significant change (p = .15). There was a significant decrease in thoracic fluid content (p = .016) and a significant increase in stroke volume variation (p = .038) systemic vascular resistance (p < .001) and left ventricular ejection time (p < .001). Other hemodynamic parameters were all comparable before and after NPV.

CONCLUSIONS

Negative pressure ventilation demonstrated an impact on hemodynamics in patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Electrical cardiometry is a feasible method of determining the hemodynamic effects of negative pressure ventilation. Thoracic fluid content significantly decreased immediately after the NPV.

摘要

背景

肺康复联合负压通气（NPV）已被证明对慢性阻塞性肺疾病（COPD）患者有益。NPV 的效果尚不清楚。本研究旨在通过心电描记术明确 COPD 患者在肺康复计划中接受 NPV 治疗时的短期血流动力学反应。

方法

这是一项回顾性观察研究，纳入了 2018 年 1 月至 2019 年 12 月期间在肺康复病房接受 NPV 治疗的 COPD 患者，以分析血流动力学结果。

结果

共纳入 30 例 COPD 患者，均在肺康复计划中接受常规 NPV 治疗。NPV 后心输出量（p<0.001）和心率（p<0.001）显著下降。而每搏量无明显变化（p=0.15）。胸腔液含量显著降低（p=0.016），而每搏量变异度（p=0.038）、全身血管阻力（p<0.001）和左心室射血时间（p<0.001）显著增加。NPV 前后其他血流动力学参数均无明显差异。