Đo lường khối lượng công việc hô hấp ở bệnh nhân thở máy

Intensive Care Medicine - Tập 16 - Trang 418-421 - 1990
G. Annat1, J. -P. Viale1
1Service de Réanimation Pavillon G, Hôpital Edouard Herriot, Lyon Cédex 03, France

Tóm tắt

Tất cả các phương pháp đánh giá khối lượng công việc hô hấp ở bệnh nhân thở máy đều chịu sự chỉ trích lý thuyết nghiêm trọng, do có nhiều giả định và xấp xỉ mà chúng dựa vào. Tuy nhiên, chúng rất đáng quan tâm trong việc cung cấp một đánh giá khách quan về khả năng của các hình thức thông khí hỗ trợ một phần khác nhau trong việc giảm khối lượng công việc hô hấp. Chúng đã được áp dụng thành công cho thông khí hỗ trợ điều khiển [29, 30], SIMV [31], và thông khí hỗ trợ bằng áp lực [10, 11].

Từ khóa


Tài liệu tham khảo

Otis AB (1964) The work of breathing. In: Fenn WO, Rahn H (eds) Handbook of physiology, section 3, vol 1. American Physiological Society, Washington DC, pp 463–476 Roussos C, Campbell EJM (1986) Respiratory muscle energetics. In: Handbook of physiology, Section 3, vol 3: Respiration. American Physiological Society, Bethesda, pp 481–509 Bertrand O, Viale JP, Annat G, Sebes F, Delafosse B, Percival C, Bui-Xuan B, Motin J (1986) Mass spectrometer system for long-term continuous measurements of VO2 and VCO2 during artificial ventilation. Med Biol Eng Comput 24:174–181 Annat G (1989) Continuous measurement of pulmonary gas exchange during mechanical ventilation. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 167–175 Bursztein S, Elwyn DH, Askanazi J, Kinney JM (1989) Evaluation of metabolic measurement equipment. In: Energy metabolism, indirect calorimetry and nutrition. Williams and Wilkins, Baltimore Hong Kong London Sidney, pp 211–228 Thung N, Herzog P, Christlieb I, Thompson WN, Danmann JF (1963) The cost of respiratory effort in postoperative cardiac patients. Circulation 28:552–559 Wilson RS, Sullivan SF, Malm JR, Bowman FO (1973) The oxygen cost of breathing following anesthesia and cardiac surgery. Anesthesiology 39:387–393 Field S, Kelly SM, Macklem PT (1982) The oxygen cost of breathing in patients with cardiorespiratory disease. Am Rev Respir Dis 126:9–13 Viale JP, Annat G, Bouffard Y, Delafosse B, Bertrand O, Motin J (1988) Oxygen cost of breathing in postoperative patients. Pressure support ventilation vs continuous positive airway pressure. Chest 93:506–509 Brochard L, Harf A, Lorino H, Lemaire F (1989) Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis 139:513–521 Annat G, Viale JP, Dereymez C, Bouffard Y, Delafosse B, Motin J (1990) Oxygen cost of breathing and diaphragmatic pressure-time index in obstructive patients during weaning with pressure support ventilation. Chest (in press) Baydur A, Behrakis PK, Zin NA, Milic Emili J (1982) A simple method for assessing the validity of the esophageal balloon technique. Am Rev Respir Dis 126:788–791 Viale JP, Annat G, Bertrand O, Godard J, Motin J (1985) Additional inspiratory work in intubated patients breathing with continuous positive airway pressure systems. Anesthesiology 63:536–539 Katz JA, Kraemer RW, Gjerde GE (1985) Inspiratory work and airway pressure with continuous positive airway pressure delivery systems. Chest 88:512–526 Viale JP, Annat G, Percival C, Bertrand O, Motin J (1986) Added inspiratory work of breathing during CPAP ventilation: comparison of two demand-valve devices with a continuous flow system. Intensive Care Med 12:374–377 Beydon L, Chasse M, Harf A, Lemaire F (1988) Inspiratory work of breathing during spontaneous ventilation using demand valves and continuous flow systems. Am Rev Respir Dis 138:300–304 Annat G, Viale JP, Motin J (1988) Inspiratory work during continuous positive airway pressure (CPAP) ventilation with new generation ventilators. Anesthesiology 69:A832 Campbell EJM, Westlake EK, Cherniack RM (1957) Simple method of estimating oxygen consumption and efficiency of the muscles of breathing. J Appl Physiol 11:303–308 Milic Emili J, Tyler JM (1963) Relation between work output of respiratory muscles and end tidal CO2 tension. J Appl Physiol 18:497–504 Agostoni E, Mead J (1964) Statics of the respiratory system. In: Handbook of physiology, Section 3, vol 1: Respiration. American Physiological Society, Washington DC, pp 387–409 Fleury B, Murciano D, Talamo C, Aubier M, Pariente R, Milic Emili E (1985) Work of breathing in patients with chronic obstructive pulmonary disease in acute respiratory failure. Am Rev Respir Dis 131:822–827 Smith TC, Marini JJ (1988) Impact of Peep on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol 53:1190–1195 Shapiro M, Wilson RK, Casar G, Bloom K, Teague R (1986) Work of breathing through different sized endotracheal tubes. Crit Care Med 14:1028–1031 McGregor M, Becklake M (1961) The relationship of oxygen cost of breathing to respiratory mechanical work and respiratory force. J Clin Invest 40:971–980 Field S, Sanci S, Grassino A (1984) Respiratory muscle oxygen consumption estimated by the pressure-time index. J Appl Physiol 57:44–51 Bellemare F, Grassino A (1982) Effect of pressure and timing of contraction on human diaphragm fatigue. J Appl Physiol 53:1190–1195 Barnard PA, Levine S (1986) Critique on application of diaphragmatic time-tension index to spontaneously breathing humans. J Appl Physiol 60:1067–1072 Martin JG, Shore S, Engel LA (1982) Effect of continuous positive airway pressure on respiratory mechanics and pattern of breathing in induced asthma. Am Rev Respir Dis 126:812–817 Marini JJ, Capps JS, Culver BH (1985) The inspiratory work of breathing during assisted mechanical ventilation. Chest 87:612–618 Marini JJ, Rodriguez RM, Lamb V (1986) The inspiratory workload of patient-initiated mechanical ventilation. Am Rev Respir Dis 134:902–906 Marini JJ, Smith TC, Lamb VJ (1988) External work output and force generation during synchronized intermittent mechanical ventilation. Am Rev Respir Dis 138:1169–1179