文摘
最常用的无创机械通气模式(NMV)交织间歇正压通气(IPPV)。压力支持通气最近变得越来越受欢迎,但其优点并没有明确定义。在一个开放的、非随机的后续研究中,我们评估了两种模式的NMV交织(IPPV)和压力控制通气(PCV)连续6个月在30个病人(24男性和6个女性,49岁+ / - 19岁)慢性呼吸衰竭(CRF)。基线评估由生理和主观数据。在所有情况下,鼻IPPV最初管理1月,紧随其后的是鼻PCV的第二个月。此后,急救员或nonresponders PCV定义根据病人的主观症状评分和/或血碳酸过多症的复发。在IPPV阶段,除了两个病人的主观和客观参数明显改善。在接下来的1个月PCV阶段,稳定保持在18例(“反应”),而10位病人被定义为“nonresponders”。在nonresponders,增加血碳酸过多症(动脉二氧化碳张力(Pa,二氧化碳):5.7 + / - 0.4到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.