Gutheil T, Pankow W, Becker H, Juhász J, Stammnitz A, Grote L, Peter J H, von Wichert P
Zentrum für Innere Medizin, Medizinische Poliklinik, Schlafmedizinisches Labor der der Philipps-Universität Marburg.
Med Klin (Munich). 1997 Apr 28;92 Suppl 1:85-9.
The aim of the present study was to evaluate if Proportional Assist Ventilation (PAV), when applied noninvasively via face mask, can reduce ventilatory effort in patients with respiratory failure. We present preliminary results of an ongoing study.
In 5 patients with respiratory failure due to different underlying disorders (pulmonary fibrosis, bilateral diaphragm paralysis, COPD) we compared the transdiaphragmal pressure-time integral. PTdi (integral off Pdi dt) after 15 minutes of noninvasive PAV to the baseline values without ventilatory support.
Four patients showed reduction of PTdi to various extend. One patient who presented low diaphragmal activity at baseline due to diaphragmal paralysis showed a slight increase in PTdi during ventilation. Mean PTdi decreased by 26.7%. PaCO2 in the 5 patients showed no significant change after 15 minutes of ventilation, thus indicating that with noninvasive PAV patients can maintain constant ventilation with reduced effort.
本研究的目的是评估经面罩无创应用比例辅助通气（PAV）是否能减轻呼吸衰竭患者的呼吸负荷。我们展示了一项正在进行的研究的初步结果。
在5例因不同潜在疾病（肺纤维化、双侧膈肌麻痹、慢性阻塞性肺疾病）导致呼吸衰竭的患者中，我们比较了无创PAV 15分钟后的跨膈压时间积分（PTdi，即Pdi dt的积分）与无通气支持时的基线值。
4例患者的PTdi有不同程度降低。1例因膈肌麻痹在基线时膈肌活动较低的患者在通气期间PTdi略有增加。平均PTdi下降了26.7%。5例患者通气15分钟后PaCO2无显著变化，这表明无创PAV可使患者在减轻呼吸负荷的情况下维持稳定通气。
