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无创家庭通气中的呼吸循环

Cycling the Breath in Noninvasive Home Ventilation.

作者信息

Arnal Jean-Michel, Khirani Sonia

机构信息

Intensive Care Unit and Home Ventilation Unit, Hôpital Sainte Musse, 83100 Toulon, France.

ASV Santé, 92230 Gennevilliers, France.

出版信息

J Clin Med. 2024 Nov 6;13(22):6673. doi: 10.3390/jcm13226673.

DOI:10.3390/jcm13226673
PMID:39597817
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11594796/
Abstract

Spontaneous/timed (ST) mode is widely used for long-term noninvasive ventilation (NIV) in adults and children. It combines controlled, assisted, and spontaneous breaths. Cycling refers to the switch from inspiration to exhalation. In ST mode, different cycling mechanisms coexist. In spontaneous breathing, cycling is set by the expiratory trigger sensitivity (TgE) based on the inspiratory flow signal, which results in variable inspiratory times (Ti) and appears to be more physiological. In the case of controlled breathing or unintentional leaks, the cycling is time-dependent according to the set backup Ti or Ti max, respectively. Cycling is an important parameter to set adequately to avoid patient-ventilator asynchronies. This article gathers all the information about cycling in long-term NIV, presenting the cycling settings for different devices, addressing cycling issues, and detailing how to set the cycling criteria. Advanced monitoring with statistics and waveforms is discussed to detect early and delayed cycling.

摘要

自主/定时（ST）模式广泛应用于成人和儿童的长期无创通气（NIV）。它结合了控制呼吸、辅助呼吸和自主呼吸。切换是指从吸气到呼气的转换。在ST模式下，不同的切换机制并存。在自主呼吸时，切换由基于吸气流量信号的呼气触发敏感度（TgE）设置，这会导致吸气时间（Ti）可变，并且似乎更符合生理情况。在控制呼吸或无意漏气的情况下，切换分别根据设置的备用Ti或Ti最大值取决于时间。切换是一个需要适当设置以避免患者与呼吸机不同步的重要参数。本文收集了有关长期无创通气中切换的所有信息，介绍了不同设备的切换设置，探讨了切换问题，并详细说明了如何设置切换标准。还讨论了使用统计数据和波形进行高级监测以检测早期和延迟切换的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/74b3804b5ba3/jcm-13-06673-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/fbde704f286d/jcm-13-06673-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/ace4d82ac939/jcm-13-06673-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/8ffeb4f9b5ce/jcm-13-06673-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/1a0c7ca8f1da/jcm-13-06673-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/f13bed869fea/jcm-13-06673-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/21bf29317698/jcm-13-06673-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/74b3804b5ba3/jcm-13-06673-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/fbde704f286d/jcm-13-06673-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/ace4d82ac939/jcm-13-06673-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/8ffeb4f9b5ce/jcm-13-06673-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/1a0c7ca8f1da/jcm-13-06673-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/f13bed869fea/jcm-13-06673-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/21bf29317698/jcm-13-06673-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1396/11594796/74b3804b5ba3/jcm-13-06673-g007.jpg

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