ASV 1.1 通气模式为儿童病输送较低的驱动压

10.08.2021

根据土耳其最近发表的一份文献,在异质儿童病人群体中,闭环通气模式产生的驱动压显著低于常规通气模式。

该随机交叉试验是在土耳其伊兹密尔 (Izmir) 的儿童疾病与外科培训研究 (Dr Behcet Uz Children's Disease and Surgery Training and Research Hospital) 医院开展的,其目的在于对比适应性支持通气 (ASV) 1.1 模式的驱动压与医生定制的 APV-CMV 模式的驱动压。共计 26 名病人入选,中位数年龄为 16 个月,具有不同的肺部状况。研究人员比较了两段采用 APV-CMV 模式和 ASV 1.1 模式的 60 分钟通气时间,通过调节设置在这两种模式下达到相同的分钟通气量。

结果表明,在 ASV 1.1 阶段较 APV-CMV 阶段,中位数驱动压显著更低(分别为 10.4 (8.5−12.1 [IQR]) 和 12.4 (10.5−15.3 [IQR]) cmH2O (p < .001))。ASV 1.1 算法选择的中位数潮气量为 6.4 (5.1−7.3 [IQR]) ml/kg,呼吸频率 41 (33−50 [IQR]) b/min,相比之下, APV-CMV 阶段中位数潮气量为 7.9 (6.8−8.3 [IQR]) ml/kg,呼吸频率 31 (26−41[IQR]) b/min。作者得出结论,ASV 1.1 模式下产生的驱动压低于 APV-CMV 模式所产生的驱动压,因此可以在异质儿童病人群体中实施持续、安全的通气。

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Ceylan, G, Topal, S, Atakul, G, et al. Randomized crossover trial to compare driving pressures in a closed-loop and a conventional mechanical ventilation mode in pediatric patients. Pediatric Pulmonology. 2021; 1- 9.

Date of Printing: 27.11.2021
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