Elliott M W, Aquilina R, Green M, Moxham J, Simonds A K
Department of Thoracic Medicine, Royal Brompton National Heart and Lung Hospitals (Chelsea), London, UK.
Anaesthesia. 1994 Apr;49(4):279-83. doi: 10.1111/j.1365-2044.1994.tb14173.x.
The aims of noninvasive ventilation include the correction of hypoventilation and unloading of inspiratory muscles. Volume cycled flow generators, bi-level positive airway pressure and continuous positive airway pressure techniques have all been used with face and nasal masks. We have compared these modes of ventilatory support, administered by a nasal mask in stable, awake outpatients with chronic obstructive pulmonary disease or neuromusculo-skeletal disease in respect of their effects on ventilation, inspiratory muscle effort and oxygen saturation. There were no clinically significant differences between the volume cycled flow generator and bi-level positive airway pressure methods; compared to spontaneous ventilation, oxygen saturation increased and inspiratory muscle effort decreased. Tidal volume increased and respiratory rate reduced, the largest changes occurring with bi-level positive airway pressure. Only the volume cycled flow generator increased minute ventilation significantly. Ventilation and inspiratory muscle effort were unaffected by continuous positive airway pressure but oxygen saturation was lower than during spontaneous ventilation. In awake, stable outpatients acclimatised to nasal ventilation there were no clinically significant differences between volume cycled flow generator and bi-level positive airway pressure techniques, but continuous positive airway pressure was less effective.
无创通气的目的包括纠正通气不足和减轻吸气肌负荷。容积控制型流量发生器、双水平气道正压通气和持续气道正压通气技术都已通过面罩和鼻罩使用。我们比较了这些通气支持模式，在稳定、清醒的慢性阻塞性肺疾病或神经肌肉骨骼疾病门诊患者中，通过鼻罩给予这些模式，观察其对通气、吸气肌做功和血氧饱和度的影响。容积控制型流量发生器和双水平气道正压通气方法之间没有临床显著差异；与自主通气相比，血氧饱和度增加，吸气肌做功减少。潮气量增加，呼吸频率降低，双水平气道正压通气时变化最大。只有容积控制型流量发生器显著增加了分钟通气量。通气和吸气肌做功不受持续气道正压通气的影响，但血氧饱和度低于自主通气时。在适应鼻通气的清醒、稳定门诊患者中，容积控制型流量发生器和双水平气道正压通气技术之间没有临床显著差异，但持续气道正压通气效果较差。
