Aufricht C, Huemer C, Frenzel C, Simbruner G
Department of Neonatal and Pediatric Intensive Care, Children's Hospital, University of Vienna, Austria.
Am J Perinatol. 1993 Mar;10(2):139-42. doi: 10.1055/s-2007-994646.
We evaluated a bedside method of assessing respiratory compliance from chest expansion, which is judged by eye and classified into three tidal volume categories, and from the inflation pressure read on the respirator's manometer. Compliance assessed by this method was compared with the compliance measured by the injection technique in 45 randomly chosen newborns ventilated for various diseases. The compliance assessed from chest expansion and inflation pressure correlated significantly with the measured compliance (r = 0.86, p < 0.001). Interobserver reliability was acceptable for clinical practice and improved within 6 months of training (weighted kappa = 0.67 versus 0.86). Within ten individuals, changes of compliance assessed by this method were also significantly correlated with those of measured compliance (r = 0.85, p < 0.01). This method, termed "optical compliance," is instantaneously and always available for all patients on ventilators without any additional apparatus and thus might improve the assessment of respiratory function in routine care and emergency situations.
我们评估了一种通过胸廓扩张来评估呼吸顺应性的床旁方法，胸廓扩张通过肉眼判断并分为三个潮气量类别，同时还根据呼吸机压力计上读取的充气压力进行评估。将通过该方法评估的顺应性与通过注射技术测量的顺应性在45例因各种疾病接受通气治疗的随机选择的新生儿中进行比较。通过胸廓扩张和充气压力评估的顺应性与测量的顺应性显著相关（r = 0.86，p < 0.001）。观察者间的可靠性对于临床实践来说是可接受的，并且在培训6个月内有所提高（加权kappa = 0.67对0.86）。在十名个体中，通过该方法评估的顺应性变化也与测量的顺应性变化显著相关（r = 0.85，p < 0.01）。这种方法称为“视觉顺应性”，无需任何额外设备即可即时且始终适用于所有使用呼吸机的患者，因此可能会改善常规护理和紧急情况下的呼吸功能评估。
