抽象的
最常用的非侵入性机械通气(NMV)的模式是体积控制的间歇性正压通气(IPPV)。压力支持通风最近变得越来越流行,但其优点尚未得到明确定义。在一项开放的非随机随访研究中,我们在6个月内评估了两种模式的NMV模式,体积控制(IPPV)和压力控制通风(PCV)(PCV),连续30例(24名男性和6名女性,年龄为49 +//- 49 +/-19岁)患有慢性呼吸衰竭(CRF)。基线评估包括生理和主观数据。在所有情况下,鼻腔IPPV最初均施用1个月,然后是鼻腔PCV的第二个月。此后,根据患者的主观症状评分和/或高碳酸血症的复发来定义对PCV的反应者或无反应者。在IPPV阶段,除两名患者外,主观和客观参数都显着改善。在接下来的1个月PCV阶段中,在18名患者(“反应者”)中保持了稳定,而将10名患者定义为“无反应者”。在无反应者中,高碳酸血症增加(动脉二氧化碳张力(PA,CO2):5.7 +/- 0.4至6.6 +/- 0.5 kpa; p <0.05),症状评分降低。 Compared with responders, nonresponders had a lower mean nocturnal arterial oxygen saturation (Sa,O2) (p < 0.05) and a higher daytime Pa,CO2 (p < 0.05) at baseline. We con clude that the majority of patients suffering from chronic respiratory failure who are initially satisfactorily ventilated with intermittent positive pressure ventilation may also be adequately maintained with pressure-controlled ventilation. However, there is a subgroup with more severe chronic respiratory failure at baseline, in whom pressure-controlled ventilation is inadequate. After 4 weeks of treatment with pressure-controlled ventilation, the subjective scores and the arterial carbon dioxide tension values reliably distinguished between long-term responders and nonresponders to pressure-controlled ventilation.