Harpin R P, Baker J P, Downer J P, Whitwell J, Gallacher W N
Crit Care Med. 1987 Sep;15(9):807-12. doi: 10.1097/00003246-198709000-00001.
We studied 20 patients (ages 43 to 84 yr), whose forced vital capacity, peak negative inspiratory pressure and alveolar-arterial gradient indicated that they were unlikely to be withdrawn rapidly from mechanical ventilation. Their mean oxygen consumption (VO2) during controlled ventilation (CV) was 292 +/- 21 (SEM) ml/min. During spontaneous ventilation (SV) through endotracheal tube and ventilator circuit, the VO2 rose significantly (p less than .001) to 323 +/- 20 ml/min. The oxygen cost of breathing (OCB) (the difference in VO2 between CV and SV) and the OCB as a fraction of the oxygen consumed during SV (OCB/VO2 SV) both correlated significantly by linear regression analysis with the total time to wean in days (-11.6 + 0.93 for OCB, r = .79; and -12.6 + 293.1 for OCB/VO2 SV, r = .84, p less than .001 for both). As the OCB was correlated with the total wean time, this variable may be a useful index of the effect of many influences on the weaning process.
我们研究了20例患者(年龄43至84岁),其用力肺活量、最大吸气负压和肺泡-动脉氧分压差表明他们不太可能迅速撤机。他们在控制通气(CV)期间的平均耗氧量(VO2)为292±21(标准误)ml/分钟。通过气管插管和呼吸机回路进行自主通气(SV)时,VO2显著升高(p<0.001)至323±20 ml/分钟。呼吸氧耗(OCB)(CV和SV之间VO2的差值)以及OCB占SV期间耗氧量的比例(OCB/VO2 SV)通过线性回归分析均与撤机总天数显著相关(OCB为-11.6 + 0.93,r = 0.79;OCB/VO2 SV为-12.6 + 293.1,r = 0.84,两者p均<0.001)。由于OCB与撤机总时间相关,该变量可能是多种因素对撤机过程影响的有用指标。