Darowski M, Gottlieb-Inacio G, Ludwigs U, Hedenstierna G
Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw.
Acta Anaesthesiol Scand. 1995 May;39(4):462-6. doi: 10.1111/j.1399-6576.1995.tb04100.x.
Standard methods for the assessment of the compliance of the respiratory system require recordings of both airway pressure and ventilatory volume. A method based on the recording of respiratory flow only, with no need of measuring airway pressure was reported some years ago. The purpose of the present study was to test a modification of this flow-recording technique. The technique is based on the measurement of inspiratory flow with and without the addition of a source of external compliance added to the inspiratory circuit. The difference in inspiratory flow between these two situations can be used to derive the compliance of the respiratory system. The method was and in patients with acute respiratory failure, and compared with a standard method based on airway pressure and inspiratory gas flow recording. Model experiments showed strong correlation between the new flow-recording method and the standard method (r = 0.99, P < 0.001) with a coefficient of variation of less than 2% with both methods. In patients with acute respiratory failure, the flow and standard methods gave similar results when no end-inspiratory pause was applied (mean difference 5 +/- 40 ml/kPa (x +/- s.d.)). The standard method gave significantly higher compliance values, different from the flow method, when an end-inspiratory pause of 10% was applied (mean difference 53 +/- 2 ml/kPa, P < 0.01). The flow method was not influenced by the use of an end-inspiratory pause.(ABSTRACT TRUNCATED AT 250 WORDS)
评估呼吸系统顺应性的标准方法需要记录气道压力和通气量。几年前报道了一种仅基于呼吸流量记录、无需测量气道压力的方法。本研究的目的是测试这种流量记录技术的一种改进方法。该技术基于在吸气回路中添加和不添加外部顺应性源的情况下测量吸气流量。这两种情况下吸气流量的差异可用于推导呼吸系统的顺应性。该方法在急性呼吸衰竭患者中进行了测试，并与基于气道压力和吸气气体流量记录的标准方法进行了比较。模型实验表明，新的流量记录方法与标准方法之间具有很强的相关性（r = 0.99，P < 0.001），两种方法的变异系数均小于2%。在急性呼吸衰竭患者中，当不应用吸气末暂停时，流量法和标准法得出的结果相似（平均差异5 +/- 40 ml/kPa（x +/-标准差））。当应用10%的吸气末暂停时，标准法得出的顺应性值明显高于流量法（平均差异53 +/- 2 ml/kPa，P < 0.01）。流量法不受吸气末暂停使用的影响。（摘要截短为250字）
