比较呼吸理疗和呼气末正压变化对重症监护病房呼吸机相关肺炎患者血气分析结果的影响

Q3 Medicine
Tanaffos Pub Date : 2023-03-01
Morteza Shahrokhi, Mohammad Gholizadeh Gerdrodbari, Seyyed Mohamad Mousavi, Sedighe Rastaghi, Farzaneh Enayati
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引用次数: 0

摘要

背景:危重病人在经历危及生命的疾病时,通常会患上呼吸机相关性肺炎(VAP),这会增加发病率、死亡率和医疗费用。本研究旨在比较呼吸理疗和增加内呼气正压(PEEP)对毛细血管造影结果的影响:这项随机对照临床试验针对重症监护室(ICU)中的 80 名 VAP 成人患者。患者被随机分配接受 5 厘米水深的 PEEP,然后适度增加 PEEP 至 10 厘米水深,或接受 5 厘米水深的 PEEP 并进行 15 分钟的呼吸理疗。两种方法都在第 1、5、10、15 和 30 分钟在毛细血管通气仪上记录数值。数据收集工具包括核对表和 MASIMO 通气记录仪:结果表明,两种方法在排出的 pCO2(二氧化碳分压)上存在显著差异(与单纯增加 PEEP 的方法(36.184mmHg)相比,呼吸理疗和 PEEP 干预法的 P2 更高(38.151mmHg))。此外,PEEP 升高法延长了第一阶段(吸气时间)和第二阶段的时间,同时缩短了第三阶段(呼气时间)的时间:结论:接受呼吸理疗后,VAP 患者的二氧化碳排泄量增加。此外,与机械通气患者的 PEEP 变化相比,物理治疗在二氧化碳排泄方面的效果更易接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the Effect of Respiratory Physiotherapy and Positive End-Expiratory Pressure Changes on Capnography Results in Intensive Care Unit Patients with Ventilator-Associated Pneumonia.

Background: While critically ill patients experience a life-threatening illness, they commonly develop ventilator-associated pneumonia (VAP) which can increase morbidity, mortality, and healthcare costs. The present study aimed to compare the effect of respiratory physiotherapy and increased positive endexpiratory pressure (PEEP) on capnography results.

Materials and methods: This randomized control clinical trial was performed on 80 adult patients with VAP in the intensive care unit (ICU). The patients were randomized to receive either PEEP at 5 cm H2O, followed by a moderate increase in PEEP to 10 cm H2O, or PEEP at 5 cm H2O with respiratory physiotherapy for 15 min. The numerical values were recorded on the capnograph at minutes 1, 5, 10, 15, and 30 in both methods. Data collection instruments included a checklist and MASIMO capnograph.

Results: As evidenced by the obtained results, the two methods significantly differed in the excreted pCO2 (partial pressure of carbon dioxide) (P<0.0001). However, the average amount of excreted pCO2 was higher in the respiratory physiotherapy and PEEP intervention (38.151mmHg) in comparison with increasing PEEP alone method (36.184mmHg). Also, PEEP elevation method prolonged the time of the first phase (inhalation time) and the second phase while shortening the third phase (exhalation time) in capnography waves.

Conclusion: CO2 excretion in patients with VAP increased after respiratory physiotherapy. Further, physiotherapy demonstrated more acceptable results in CO2 excretion compared with PEEP changes in mechanically ventilated patients.

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来源期刊
Tanaffos
Tanaffos Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.10
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