RT期刊文章SR电子T1 Autotitrating外部呼气末正压通气废除呼气流量限制在潮汐呼吸严重慢性阻塞性肺病患者:一项生理研究摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 1902234 10.1183/13993003.02234 -2019签证官56是3 A1 Eui-Sik Suh A1 Pasquale任A1副研究员Mandal A1彼得·希尔A1乔治Kaltsakas A1帕特里克·b·墨菲A1罗伯特Romano A1约翰Moxham A1拉斐尔Dellaca A1尼古拉斯·哈特2020年UL 188bet官网地址//www.qdcxjkg.com/content/56/3/1902234.abstract AB背景最优非侵入式应用程序的外部呼气末正压通气(EPAP)废除tidal-breathing呼气流量限制(EFLT)和减少内在呼气末正压通气(PEEPi)是具有挑战性的慢性阻塞性肺病患者。我们调查是否auto-titrating EPAP,使用强迫振荡技术(FOT)检测和废除EFLT,会减少PEEPi,呼吸和神经呼吸驱动(”)的严重慢性阻塞性肺病患者。方法慢性阻塞性肺病慢性呼吸衰竭患者接受auto-titration EPAP使用FOT-based EFLT检测算法。最优EPAP被确认后,手动滴定法进行评估”(使用隔膜和胸骨旁的肋间肌肌电图,EMGdi EMGpara,分别),transdiaphragmatic吸气压力波动(ΔPdi) transdiaphragmatic pressure-time产品(PTPdi)和PEEPi EPAP水平下cmH2O第2至3 cmH2O最佳EPAP之上。结果10位病人登记(65±6岁;男性60%;身体质量指数为27.6±7.2 kg.m−2;用力呼气量在1 s 28.4±8.3%预测),八个EFLT,优化EPAP 9(范围42)cmH2O。”从基线EPAP 1 cmH2O低于最优EPAP EMGdi和最佳EPAP EMGpara。此外,在最优EPAP PEEPi (0.80±1.27 cmH2O和1.95±1.70 cmH2O;与基线相比p < 0.05)降低。PTPdi (10.3±7.8 cmH2O·s−1和16.8±8.8 cmH2O·s−1; p<0.05) and ΔPdi (12.4±7.8 cmH2O versus 18.2±5.1 cmH2O; p<0.05) were reduced at optimal EPAP+1 cmH2O compared with baseline.Conclusion Autotitration of EPAP, using a FOT-based algorithm to abolish EFLT, minimises transdiaphragmatic pressure swings and NRD in patients with COPD and chronic respiratory failure.An automated ventilator algorithm, using the forced oscillation technique to detect tidal breathing expiratory flow limitation (EFLT), identifies the optimum EPAP at which EFLT is abolished without causing unnecessary lung hyperinflation https://bit.ly/2WNyhWP