Chang Hsiao-Yun, Hsiao Hsiang-Chun, Chang Hwai-Luh
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan.
Department of Nursing, Jhong-Jheng Spine & Orthopedics Hospital, Kaohsiung.
SAGE Open Nurs. 2022 Jul 7;8:23779608221111717. doi: 10.1177/23779608221111717. eCollection 2022 Jan-Dec.
Patients require prolonged mechanical ventilation to overcome respiratory failure in the chronic respiratory care ward; however, how to facilitate ventilator weaning using a nurse-led strategy is limited.
This study aimed to examine the impact of adjusting ventilator trigger sensitivity as inspiratory muscle training on weaning parameters in patients with prolonged ventilator dependence.
Multiple pre-test-post-test with a non-equivalent control group design was conducted at a chronic respiratory care ward in southern Taiwan. A convenience sampling method was used to recruit patients who received prolonged mechanical ventilation for more than 21 days into control ( = 20) and intervention groups ( = 22). Adjustment of ventilator trigger sensitivity started from 10% of the initial maximum inspiratory pressure and increased to 40% after a training period of six weeks. The weaning parameters were collected for pre-test and multiple post-tests, and statistical analysis of treatment effects was performed using the generalized estimating equation.
Magnitude of weaning parameters was significantly higher in the intervention group after the six-week training, including maximum inspiratory pressure, rapid shallow breathing index, tidal volume, and ratio of arterial-to-inspired oxygen.
Adjustment of ventilator trigger sensitivity as inspiratory muscle training can help prolonged ventilator-dependent patients improve their respiratory muscle strength, breathing patterns, and oxygenation.
在慢性呼吸护理病房中，患者需要长时间机械通气来克服呼吸衰竭；然而，如何采用以护士为主导的策略促进撤机的相关研究有限。
本研究旨在探讨将调整呼吸机触发灵敏度作为吸气肌训练对长期依赖呼吸机患者撤机参数的影响。
在台湾南部的一家慢性呼吸护理病房采用非等效对照组设计进行多次前测-后测。采用便利抽样法招募接受机械通气超过21天的患者，分为对照组（n = 20）和干预组（n = 22）。呼吸机触发灵敏度从初始最大吸气压力的10%开始调整，经过六周的训练期后增加到40%。收集撤机参数进行前测和多次后测，并使用广义估计方程对治疗效果进行统计分析。
经过六周的训练后，干预组的撤机参数幅度显著更高，包括最大吸气压力、快速浅呼吸指数、潮气量和动脉血氧分压与吸入氧浓度之比。
将调整呼吸机触发灵敏度作为吸气肌训练可帮助长期依赖呼吸机的患者提高呼吸肌力量、呼吸模式和氧合水平。
