国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2015年
1期
51-56
,共6页
单肺通气%机械通气模式
單肺通氣%機械通氣模式
단폐통기%궤계통기모식
One lung ventilation%Mechanical ventilation modes
背景 单肺通气(one lung ventilation,OLV)实施过程中最常见的并发症是低氧血症,也是麻醉医师遇到的最严重的挑战. 目的 近来研究表明OLV本身能够引起低氧血症和急性肺损伤(acute lung injury,ALI).因此,如何实施OLV时机械通气模式,降低肺内分流率(pulmonary shunt fraction,Qs/Qt)、预防低氧血症一直是临床研究的热点. 内容 综述提高吸入氧分数(fraction of inspiration O2,FiO2)、控制通气模式、高频通气(high frequency ventilation,HFV)、潮气量(tidal volume,Vt)、反比通气、部分液体通气(partial liquid ventilation,PLV)、持续气道正压通气(continuous positive airway pressure,CPAP)、呼气末正压通气(positive end-expiratory pressure,PEEP)等通气模式,以及实施联合多种模式的保护性肺通气策略. 趋向 综合运用多种预防OLV期间低氧血症的通气模式取得良好的效果,但应针对患者和手术情况制定OLV时机械通气模式.
揹景 單肺通氣(one lung ventilation,OLV)實施過程中最常見的併髮癥是低氧血癥,也是痳醉醫師遇到的最嚴重的挑戰. 目的 近來研究錶明OLV本身能夠引起低氧血癥和急性肺損傷(acute lung injury,ALI).因此,如何實施OLV時機械通氣模式,降低肺內分流率(pulmonary shunt fraction,Qs/Qt)、預防低氧血癥一直是臨床研究的熱點. 內容 綜述提高吸入氧分數(fraction of inspiration O2,FiO2)、控製通氣模式、高頻通氣(high frequency ventilation,HFV)、潮氣量(tidal volume,Vt)、反比通氣、部分液體通氣(partial liquid ventilation,PLV)、持續氣道正壓通氣(continuous positive airway pressure,CPAP)、呼氣末正壓通氣(positive end-expiratory pressure,PEEP)等通氣模式,以及實施聯閤多種模式的保護性肺通氣策略. 趨嚮 綜閤運用多種預防OLV期間低氧血癥的通氣模式取得良好的效果,但應針對患者和手術情況製定OLV時機械通氣模式.
배경 단폐통기(one lung ventilation,OLV)실시과정중최상견적병발증시저양혈증,야시마취의사우도적최엄중적도전. 목적 근래연구표명OLV본신능구인기저양혈증화급성폐손상(acute lung injury,ALI).인차,여하실시OLV시궤계통기모식,강저폐내분류솔(pulmonary shunt fraction,Qs/Qt)、예방저양혈증일직시림상연구적열점. 내용 종술제고흡입양분수(fraction of inspiration O2,FiO2)、공제통기모식、고빈통기(high frequency ventilation,HFV)、조기량(tidal volume,Vt)、반비통기、부분액체통기(partial liquid ventilation,PLV)、지속기도정압통기(continuous positive airway pressure,CPAP)、호기말정압통기(positive end-expiratory pressure,PEEP)등통기모식,이급실시연합다충모식적보호성폐통기책략. 추향 종합운용다충예방OLV기간저양혈증적통기모식취득량호적효과,단응침대환자화수술정황제정OLV시궤계통기모식.
Background Hypoxemia is one of the most common complications and the most important challenge during one lung ventilation(OLV).Objective Recent studies have shown that OLV can cause severe hypoxemia and acute lung injury (ALI).How to implement OLV strategy to reduce pulmonary shunt fraction (Qs/Qt) and prevent hypoxemia has always been a research hot spot.Content The strategy used to improve oxygenation involve increased inspired oxygen fraction (FiO2),control ventilation modes,high frequency ventilation (HFV),tidal volume(Vt),inverse ratio ventilation,partial liquid ventilation (PLV),continuous positive airway pressure (CPAP),positive end-expiratory pressure (PEEP) and combined multiple protective ventilation strategies.Trend The combined ventilation strategy can prevent hypoxemia during OLV.But mechanical ventilation modes should be set on the basis of patient's condition and operation.
