Zaccaria S, Zaccaria E, Zanaboni S, Patessio A, Braghiroli A, Spada E L, Donner C F
Clinica del Lavoro Foundation, Institute of Care and Research, Medical Center of Rehabilitation, Veruno (NO), Italy.
Monaldi Arch Chest Dis. 1993;48(2):161-4.
The aim of the study was to determine whether intermittent positive pressure ventilation (IPPV), delivered either by nasal mask or by tracheostomy, is able to improve alveolar gas exchange in kyphoscoliotic patients with respiratory failure. We evaluated 17 patients, 10 females and 7 males, aged 52 +/- 12 (mean +/- SD) yrs. Eight had severe respiratory failure (arterial oxygen tension (PaO2) 53.2 +/- 9.3 mmHg (7.1 +/- 1.2 kPa); arterial carbon dioxide tension (PaCO2) 73.3 +/- 12.5 mmHg (9.7 +/- 1.6 kPa), breathing supplemental oxygen), and were put on IPPV via tracheostomy (TIPPV). The others (PaO2 54.5 +/- 5.5 mmHg (7.3 +/- 0.7 kPa); PaCO2 57.9 +/- 7 mmHg (7.7 +/- 0.9 kPa), breathing air), were put on IPPV via nasal mask (NIPPV). Home mechanical ventilation (HMV) was performed at night (7 +/- 1 h) by means of a volume-cycled pressure respirator in control mode. The frequency was adapted to the patient's spontaneous respiratory rate, and then eventually modified according to blood gases. A silicone mask was moulded onto the patient's nose. Supplemental oxygen (to maintain arterial oxygen saturation (SaO2) > 90%) was used only for tracheostomized patients, whereas NIPPV was performed with fractional inspiratory oxygen (FIO2) 21%. Arterial blood samples were obtained for all patients in steady-state condition, 8 +/- 1 h from the withdrawal, breathing air, after 1 and 6 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定经鼻面罩或气管造口进行的间歇性正压通气（IPPV）是否能够改善脊柱后凸侧凸型呼吸衰竭患者的肺泡气体交换。我们评估了17例患者，其中女性10例，男性7例，年龄为52±12（平均±标准差）岁。8例患有严重呼吸衰竭（动脉血氧分压（PaO2）53.2±9.3 mmHg（7.1±1.2 kPa）；动脉血二氧化碳分压（PaCO2）73.3±12.5 mmHg（9.7±1.6 kPa），呼吸补充氧气），通过气管造口进行IPPV（TIPPV）。其他患者（PaO2 54.5±5.5 mmHg（7.3±0.7 kPa）；PaCO2 57.9±7 mmHg（7.7±0.9 kPa），呼吸空气），通过鼻面罩进行IPPV（NIPPV）。夜间（7±1小时）通过容量控制压力呼吸器以控制模式进行家庭机械通气（HMV）。频率根据患者的自主呼吸频率进行调整，然后最终根据血气进行修改。将硅胶面罩塑形贴合患者鼻部。仅对气管造口患者使用补充氧气（以维持动脉血氧饱和度（SaO2）>90%），而NIPPV使用吸入氧分数（FIO2）21%进行。在治疗1个月和6个月后，在所有患者处于稳态条件下，撤机8±1小时后，呼吸空气时采集动脉血样本。（摘要截选至250字）
