一种新的方程成功计算出了保护性通气的潮气量。
A NOVEL EQUATION SUCCESSFULLY CALCULATES TIDAL VOLUMES FOR LUNG PROTECTIVE VENTILATION.
机构信息
Department of Emergency Medicine; Department of Anesthesiology, Division of Critical Care Anesthesia, University of California, San Diego, San Diego, California.
Department of Anesthesiology, Division of Critical Care Anesthesia, University of California, San Diego, San Diego, California.
出版信息
J Emerg Med. 2023 Jul;65(1):e1-e8. doi: 10.1016/j.jemermed.2023.04.007. Epub 2023 Apr 25.
BACKGROUND
Early application of low-tidal-volume ventilation (LTVV) has been associated with improved outcomes in the emergency department (ED) and intensive care unit (ICU), but is not consistently applied. The perceived complexity of calculating an ideal body weight (IBW)-based tidal volume (Vt) may contribute to this disparity. We hypothesized that a simplified equation could successfully predict LTVV.
OBJECTIVE
To create a memorable, single-step, sex-independent equation to estimate LTVV based on height.
METHODS
We conducted a retrospective observational cohort study of patients who received mechanical ventilation (MV) at 2 EDs from January 2016 to June 2019. Data were abstracted by automatic query. Patients < 18 years old, < 60 inches in height, and with implausible or incomplete data were excluded. LTVV was defined as ≤ 8 mL/kg IBW. We created a formula predicting a 6-8-mL/kg IBW Vt. We applied this formula to a population of ICU patients in the same health care system who received MV from January 2017 to December 2019 using the same exclusion criteria. The outcome was whether the equation predicted a 6-8-mL/kg IBW Vt.
RESULTS
A total of 982 ED patients were included; 753 (76.7%) had an initial Vt < 8 mL/kg IBW. The equation Vt = 20*(Ht-60) + 300 was derived. A total of 3720 ICU patients were included. The Vt equation successfully predicted a Vt of 6-8 mL/kg IBW in 3720 (100%) of ICU patients.
CONCLUSIONS
A novel equation successfully predicted a 6-8-mL/kg IBW Vt in a cohort of patients with height ≥ 60 inches.
背景
在急诊科（ED）和重症监护病房（ICU）中，早期应用小潮气量通气（LTVV）与改善预后相关，但并未得到一致应用。计算理想体重（IBW）为基础的潮气量（Vt）的复杂性可能是导致这种差异的原因之一。我们假设一个简化的方程可以成功预测 LTVV。
目的
创建一个简单易记、单步、性别独立的方程，基于身高来估计 LTVV。
方法
我们对 2016 年 1 月至 2019 年 6 月期间在 2 家 ED 接受机械通气（MV）的患者进行了回顾性观察队列研究。数据通过自动查询提取。排除年龄<18 岁、身高<60 英寸、数据不可信或不完整的患者。LTVV 定义为≤8mL/kg IBW。我们创建了一个预测 6-8mL/kg IBW Vt 的公式。我们将该公式应用于同一医疗保健系统中在 2017 年 1 月至 2019 年 12 月期间接受 MV 的 ICU 患者人群中，使用相同的排除标准。结果是该公式是否预测了 6-8mL/kg IBW 的 Vt。
结果
共纳入 982 名 ED 患者，753 名（76.7%）患者初始 Vt<8mL/kg IBW。得出的方程为 Vt=20*（Ht-60）+300。共纳入 3720 名 ICU 患者。Vt 方程成功预测了 3720 名（100%）ICU 患者的 6-8mL/kg IBW Vt。
结论
一个新的方程成功地预测了身高≥60 英寸的患者群体中 6-8mL/kg IBW 的 Vt。
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