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[两种使患者脱离呼吸机的方法(有和没有间歇指令通气)。对22例急性(IRA)或慢性呼吸衰竭患者的比较研究(作者译)]

[Two methods of weaning patients from respirators (with and without IMV). A comparative study in 22 subjects with acute (IRA) or chronic respiratory failure (author's transl)].

作者信息

Muir J F, Aubry P, Levi-Valensi P

出版信息

Rev Fr Mal Respir. 1982;10(2):131-41.

PMID:6954587
Abstract

22 patients (4 female, 18 male) suffering from severe chronic obstructive respiratory failure (IRCO), were given artificial ventilation because of a super-imposed acute respiratory failure (IRA). The object of this study was to compare different methods of weaning patients from the ventilators using either intermittent mandatory ventilation (IMV) or an automatically triggered ventilation (VAD). Both blood gases in the acute phase and the functional data collected before the acute exacerbation failed to show any statistical difference between the two groups. The reduction of ventilation in the group of patients weaned by the technique of IMV did not appear statistically significant as shown by the following facts : controlled ventilation (IMV : 2.45 +/- 2.06 days; VAD : 4.72 +/- 3.89 days) : total duration of ventilation (IMV : 7.35 +/- 2.15; VAD : 8.54 +/- 6.56 days). The PaO2 of the subjects weaned by the technique IMV appeared higher before extubation (P less than 0.02) than the PaO2 obtained after weaning on VAD. In patients presenting with an acute exacerbation of chronic obstructive respiratory failure secondary to a bronchial infection the different techniques of weaning used (whether VAD or IMV) appear identical as regards the total duration of ventilation.

摘要

22例(4例女性,18例男性)患有严重慢性阻塞性呼吸衰竭(IRCO)的患者,因叠加急性呼吸衰竭(IRA)而接受人工通气。本研究的目的是比较使用间歇强制通气(IMV)或自动触发通气(VAD)使患者脱机的不同方法。急性期的血气和急性加重前收集的功能数据均未显示两组之间存在任何统计学差异。通过IMV技术脱机的患者组通气量的减少在统计学上不显著,如下所示:控制通气(IMV:2.45±2.06天;VAD:4.72±3.89天);通气总时长(IMV:7.35±2.15;VAD:8.54±6.56天)。通过IMV技术脱机的受试者在拔管前的动脉血氧分压(PaO2)(P<0.02)高于通过VAD脱机后的PaO2。在因支气管感染继发慢性阻塞性呼吸衰竭急性加重的患者中,所采用的不同脱机技术(无论是VAD还是IMV)在通气总时长方面似乎相同。

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