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猫用声门上气道装置通气技术的比较研究:容量控制与压力控制技术。

Comparative study of ventilation techniques with supraglottic airway devices in cats: volume-controlled vs pressure-controlled techniques.

机构信息

Surgery Unit, Kasetsart University Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand.

HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Lak Si, Bangkok, Thailand.

出版信息

J Feline Med Surg. 2024 Jan;26(1):1098612X231225353. doi: 10.1177/1098612X231225353.

DOI:10.1177/1098612X231225353
PMID:38294899
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10949876/
Abstract

OBJECTIVES

This study compared the effectiveness of a new supraglottic airway device (SGAD) in cats undergoing anaesthesia using two types of mechanical ventilation: volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV).

METHODS

A total of 13 healthy cats (five male, eight female; median age 2 years [range 1-3]) were randomly allocated to either VCV or PCV. Five tidal volumes (6, 8, 10, 12 and 14 ml/kg) and five peak inspiratory pressures (4, 5, 6, 7 and 8 cmHO) were randomly applied with a minute ventilation of 100 ml/kg/min. Various parameters, such as blood pressure, gas leakage, end-tidal CO (ETCO) and work of breathing (WOB), were measured while using VCV or PCV.

RESULTS

The occurrence of hypotension (mean arterial blood pressure <60 mmHg) was slightly less frequent with VCV (38 events, 65 ventilating sessions) than with PCV (40 events, 65 ventilating sessions), but this difference did not reach statistical significance ( = 0.429). The number of leakages did not differ between the VCV group (3 events, 65 ventilating sessions) and the PCV group (3 events, 65 ventilating sessions) ( = 1.000). Hypercapnia was identified when using VCV (10 events, 65 ventilating sessions) less frequently than when using PCV (17 events, 65 ventilating sessions), but this difference did not reach statistical significance ( = 0.194). The study found a significantly higher WOB in the PCV group compared with the VCV group ( <0.034).

CONCLUSIONS AND RELEVANCE

The present results suggested that both VCV and PCV can be used with an SGAD during anaesthesia, with VCV preferred for prolonged mechanical ventilation due to its lower workload. Adjusting tidal volume or inspiratory pressure corrects hypercapnia.

摘要

目的

本研究比较了在使用两种机械通气方式(容量控制通气(VCV)和压力控制通气(PCV))时,一种新型声门上气道装置(SGAD)在猫麻醉中的效果。

方法

总共 13 只健康猫(5 只雄性,8 只雌性;中位年龄 2 岁[范围 1-3])被随机分配到 VCV 或 PCV 组。以每分钟 100ml/kg 的通气量随机应用五个潮气量(6、8、10、12 和 14ml/kg)和五个峰压(4、5、6、7 和 8cmH2O)。在使用 VCV 或 PCV 时,测量了血压、气体泄漏、呼气末 CO(ETCO)和呼吸功(WOB)等各种参数。

结果

低血压(平均动脉压<60mmHg)的发生在 VCV 组(38 次事件,65 次通气)比 PCV 组(40 次事件,65 次通气)略少,但差异无统计学意义(=0.429)。VCV 组(3 次事件,65 次通气)和 PCV 组(3 次事件,65 次通气)的泄漏次数无差异(=1.000)。与使用 PCV 相比,使用 VCV 时发生高碳酸血症的次数较少(10 次事件,65 次通气),但差异无统计学意义(=0.194)。研究发现 PCV 组的 WOB 明显高于 VCV 组(<0.034)。

结论和相关性

本研究结果表明,在麻醉期间,SGAD 可以与 VCV 和 PCV 一起使用,由于其较低的工作量,因此更适合长时间机械通气。调整潮气量或吸气压力可纠正高碳酸血症。

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Different Inspiratory Flow Waveform during Volume-Controlled Ventilation in ARDS Patients.急性呼吸窘迫综合征(ARDS)患者容量控制通气时不同的吸气流量波形
J Clin Med. 2021 Oct 17;10(20):4756. doi: 10.3390/jcm10204756.
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