Kilger E, Briegel J, Haller M, Hummel T, Groh J, Dienemann H, Welz A, Forst H
Institut für Anästhesiologie, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
Med Klin (Munich). 1995 Apr;90(1 Suppl 1):26-8.
Non-invasive mechanical ventilation (NIPPV) is an accepted choice of treatment in patients with chronic pulmonary disease and/or acute respiratory failure. Recently NIPPV was also proposed in the postoperative weaning period.
Six of 30 patients after lung transplantation were were extubated despite a weaning failure was predicted using well accepted weaning criteria. Therefore, the 6 patients were treated with intermittent-noninvasive ventilation using assisted modes of mechanical ventilation (PSV/CPAP).
Both, oxygenation (increase in paO2: 18 mm Hg during PSV, 11 mm Hg during CPAP) and pulmonary mechanics (decrease in respiratory rate: 14/min during PSV, 10/min during CPAP; increase in tidal volume: 5 ml/kg during PSV, 3 ml/kg KG during CPAP) improved and the energy expenditure decreased (19% during PSV, 12% during CPAP).
Non-invasive ventilation after lung transplantation enables earlier extubation and prevents weaning failure.
无创机械通气(NIPPV)是慢性肺部疾病和/或急性呼吸衰竭患者公认的治疗选择。最近,NIPPV也被应用于术后撤机阶段。
30例肺移植术后患者中,尽管根据公认的撤机标准预测撤机失败,但仍有6例患者成功拔管。因此,对这6例患者采用机械通气辅助模式(PSV/CPAP)进行间歇性无创通气治疗。
氧合(PSV期间动脉血氧分压升高18mmHg,CPAP期间升高11mmHg)和肺力学(呼吸频率降低:PSV期间为14次/分钟,CPAP期间为10次/分钟;潮气量增加:PSV期间为5ml/kg,CPAP期间为3ml/kg)均得到改善,能量消耗降低(PSV期间降低19%,CPAP期间降低12%)。
肺移植术后无创通气可实现早期拔管并防止撤机失败。