两种自主呼吸测试方法在肝移植患者脱离呼吸机时的应用

被引：3

作者：

李宁

娄晓宁

机构：

[1] 解放军总医院重症监护科

[2] 解放军总医院呼吸科

来源：

解放军护理杂志 | 2005年 / 07期

关键词：

肝移植; 机械通气; 气管插管; 护理;

D O I：

暂无

中图分类号：

R473.6 [外科护理学];

学科分类号：

摘要：

目的在程序化脱离呼吸机拔出气管插管的过程中,分别采用T型管和压力支持通气(pressure suppsrt venti-lation,PSV)对肝移植术后患者进行30m in的自主呼吸试验(spontaneous breath ing trial,SBT),比较两者的临床效果。方法28例患者随机分为T型管组(n=12)和PSV组(n=16)。程序化拔除气管插管分两个步骤进行,即检测阶段和SBT阶段。当患者完成SBT阶段,而且呼吸频率≤35次/m in,PaO2≥70 mmHg,即可拔出气管插管。结果两组患者均成功进行了SBT、拔出气管插管。T型管组在30 m in时完成SBT者为10例(10/12),PSV组为13例(13/16)。两组患者平均机械通气时间分别为(22.23±17.86)h(T型管组)和(31.91±34.11)h(PSV组),P=0.3805;拔除气管插管前血清白蛋白、血红蛋白含量没有差别,但均低于正常值。结论应用T型管和PSV进行30m in的SBT,临床结果相似。短时间(<48 h)接受机械通气的非COPD患者,血中低水平的血清白蛋白、血红蛋白可能对拔除气管插管影响不大。

引用

页码：8 / 10

页数：3

共 9 条

[1] Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial. Kham ieesM,Raju P,DeG irolamo A,et al. Chest . 2001
[2] W ork of breathing after extubation. Shaya AM,Nathan SD,Beriman MJ,et al. Chest . 1995
[3] Four year experience with a unit for long-term ventilaton(Respiratory Special Care Unit) at the C leveland C linic Foundation. Asok D,R ichard R,Edward M,et al. Chest . 1999
[4] Inspiratory pressure support compensates for the additional work of breathing caused by the endotracheal tube. Brochard L,Rua F,Lorino H,et al. Anesthesiology . 1991
[5] C linical characteristics, respiratory functional parameters, and outcome of a two-hour T-piece trial in patients weaning from mechanical ventilation. Vallverdu I,CalafN,SubiranaM,et al. American Journal of Respiratory and Critical Care Medicine . 1998
[6] Effect on the duration ofmechanical ventilation of identifying patients capable of breathing spontaneously. E ly EW,BakerAM,Dunagan DP,et al. The New England Journal of Medicine . 1996
[7] Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Esteban A,A lia I,Tobin MJ,et al. American Journal of Respiratory and Critical Care Medicine . 1999
[8] The cost of respiratory care in mechanically ventilated patients with chronic obstructive pulmonary disease. E ly EW,BakerAM,Evans GW,et al. Critical Care Medicine . 2000
[9] Independent effects of etiology of failure and time to reintubation on outcome for patients failing extubation. Epstein SK,C iubotaru RL. American Journal of Respiratory and Critical Care Medicine . 1998

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