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中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (02) : 266 -268. doi: 10.3877/cma.j.issn.1674-6902.2023.02.032

短篇论著

短暂呼气末阻塞法用于指导机械通气患者撤机的临床分析
林金锋1, 张素燕1, 田李均1, 曹志龙1, 徐俊贤1, 韩旭东1,()   
  1. 1. 226000 江苏,南通大学附属南通第三医院 南通市第三人民医院重症医学科
  • 收稿日期:2022-11-17 出版日期:2023-04-25
  • 通信作者: 韩旭东
  • 基金资助:
    南通市卫生健康委员会科研立项课题(MA2020016)

Clinical study of transient end expiratory occlusion maneuver for guiding mechanically ventilated patients to weaning

Jinfeng Lin1, Suyan Zhang1, Lijun Tian1   

  • Received:2022-11-17 Published:2023-04-25
引用本文:

林金锋, 张素燕, 田李均, 曹志龙, 徐俊贤, 韩旭东. 短暂呼气末阻塞法用于指导机械通气患者撤机的临床分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(02): 266-268.

Jinfeng Lin, Suyan Zhang, Lijun Tian. Clinical study of transient end expiratory occlusion maneuver for guiding mechanically ventilated patients to weaning[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(02): 266-268.

急性呼吸衰竭(acute respiratory failure, ARF)是重症医学科的常见病症,机械通气是治疗呼吸衰竭的重要手段[1,2,3]。机械通气中,保留自主呼吸一直是传统的推荐方法[4]。过度自主呼吸努力会促进肺损伤。Yoshida等首次提出了"患者自戕性肺损伤(patient self-inflicted lung injury, P-SILI)"的概念[5]。由于过度呼吸努力,导致病情快速恶化[6]。恰当的自主呼吸强度是顺利撤机拔管的重要前提[7]。分析患者自主呼吸强度的方法,如膈肌电活动测定,食道压力等,具有创伤性。近期提出了短暂呼气末阻塞法(TEOM)监测自主呼吸努力强度,简单易行,重复性强,安全[8]。本文收集101例行机械通气的患者资料,分析TEOM用于指导撤机的准确性,报道如下。

图1 短暂呼气末阻塞法
表1 三个指标对预测成功拔管的准确性
表2 SBT和指标3对预测成功拔管的准确性
1
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23
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