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一种估算机械通气患者功能残气量的简单方法。

A simple method to estimate functional residual capacity in mechanically ventilated patients.

作者信息

Fretschner R, Deusch H, Weitnauer A, Brunner J X

机构信息

Klinik für Anaesthesiologie und Transfusionsmedizin der Universität Tübingen.

出版信息

Intensive Care Med. 1993;19(7):372-6. doi: 10.1007/BF01724875.

Abstract

OBJECTIVE

The aim of the present study was to evaluate a simplified method for FRC measurement.

DESIGN

Accuracy and precision of the method were assessed in a physical lung model; reproducibility was tested in 10 mechanically ventilated patients. In each patient FRC was measured at three PEEP levels.

SETTING

Post-operative intensive care unit in a university hospital.

MEASUREMENTS AND RESULTS

Gas flow, CO2 concentration, and O2 concentration were measured during in- and expiration by pneumotachography, a mainstream capnometer and a sidestream O2-analyser. For FRC-measurement inspiratory O2 concentration was changed by 30%. FRC was determined as mean value of a N2 washout and N2 washin procedure. Evaluation of this method in a lung model shows a good correlation between FRC set in the lung model and FRC measured (FRC measured = 1.028*FRG model + 22.92 ml; r2 = 0.957; n = 30). The mean difference was 4.4% of FRC-reference (range -8.4% to +21.7%). Duplicate determinations in 10 mechanically ventilated patients differed by an average of -2.7% (range -30.1% to +27.3%).

CONCLUSION

Our results suggest that the proposed method can be used in daily clinical work.

摘要

目的

本研究旨在评估一种简化的功能残气量(FRC)测量方法。

设计

在物理肺模型中评估该方法的准确性和精密度;在10例机械通气患者中测试其可重复性。在每位患者中,于三个呼气末正压(PEEP)水平测量FRC。

地点

大学医院的术后重症监护病房。

测量与结果

通过呼吸流速仪、主流二氧化碳监测仪和旁流氧气分析仪在吸气和呼气过程中测量气体流量、二氧化碳浓度和氧气浓度。为测量FRC,将吸气氧气浓度改变30%。FRC通过氮洗脱和氮回洗程序的平均值来确定。在肺模型中对该方法的评估显示,肺模型中设定的FRC与测量的FRC之间具有良好的相关性(测量的FRC = 1.028×FRC模型 + 22.92 ml;r² = 0.957;n = 30)。平均差异为FRC参考值的4.4%(范围为 -8.4%至 +21.7%)。10例机械通气患者的重复测定平均相差 -2.7%(范围为 -30.1%至 +27.3%)。

结论

我们的结果表明,所提出的方法可用于日常临床工作。

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