CAJ | 학술논문

目的评价改良自主呼吸诱发试验(modified apnea test,MAT)在脑死亡判定中的安全性及可行性.方法采用前瞻性自身对照研究.监测43例脑死亡判定患者在改良自主呼吸诱发试验期间的呼吸运动、血液动力学及氧合,并对试验前后的心率(HR)、有创动脉血压(ABP)、动脉血酸碱度(pH)、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)进行测定比较.计量资料以均数±标准差(x±s)表示,进行配对资料t检验.非正态分布采用配对符号等级秩次检验.所有试验均获得了患者亲属的同意,并履行了国内外相关法律法规所规定的程序.结果 43例患者进行了85次改良自主呼吸诱发试验,试验期间血液动力学和氧合稳定,结果均为阳性.89.4%的试验在4 min完成,10.6%在8min完成;试验期间PaCO2上升值的均数为(23.1±4.8),平均CO2上升速率为5.3mmHg/min.结论改良自主呼吸诱发试验可应用于脑死亡判定,作为自主呼吸诱发试验有益的补充.
목적 평개개량자주호흡유발시험(modified apnea test,MAT)재뇌사망판정중적안전성급가행성.방법 채용전첨성자신대조연구.감측43례뇌사망판정환자재개량자주호흡유발시험기간적호흡운동、혈액동역학급양합,병대시험전후적심솔(HR)、유창동맥혈압(ABP)、동맥혈산감도(pH)、동맥혈이양화탄분압(PaCO2)、동맥혈양분압(PaO2)진행측정비교.계량자료이균수±표준차(x±s)표시,진행배대자료t검험.비정태분포채용배대부호등급질차검험.소유시험균획득료환자친속적동의,병리행료국내외상관법율법규소규정적정서.결과 43례환자진행료85차개량자주호흡유발시험,시험기간혈액동역학화양합은정,결과균위양성.89.4%적시험재4 min완성,10.6%재8min완성;시험기간PaCO2상승치적균수위(23.1±4.8),평균CO2상승속솔위5.3mmHg/min.결론 개량자주호흡유발시험가응용우뇌사망판정,작위자주호흡유발시험유익적보충.
Objective To evaluate the safety and feasibility of the modified apnea test (MAT) for brain death evaluation. Method A prospective, controlled clinical study was carried out. Forty-three patients with suspected brain death underwent a total of 85 MATs. The patient's spontaneous breathing, hemodynamics and oxy genarion were monitored during MAT; arterial blood pH, PaCO2, PaO2 were measured before and after the MAT. Paired t test was used for statistical analysis to determine significant differences in measurements before and after MAT on the same patient. The Wilcoxon Signed-Rank Test was used to determine statistical significance for skew distribution of PaO2 before and after apnea testing. Informed consent was obtained from the kinfolk of all participants and all of the procedures were done in accordance with national and international laws and policies. Results Hemodynamics and oxygenarion were stable in all patients during MAT, and none regained spontaneous respiration. About 89.4% of tests were completed within 4 minutes, and 10.6% within 8 minutes. The mean value of Pa CO2 rise was (23.1 ±4.8), and the average rate of PaCO2 increase was 5.3 mmHg per minute. Conclusions Modified apnea test can be done safely for brain death evaluation and is a useful supplement to the common apnea test.