https://www.journalmechanicalventilation.com/rapid-review-of-patient-ventilator-dyssynchrony/

D. Garner, Priyank Patel
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引用次数: 0

摘要

患者呼吸机不同步(PVD)通常被描述为患者与呼吸机“斗争”。事实上,有许多形式的不同步,其中一些可能非常微妙。如果早期未被识别,不同步会引起患者不适,增加肺损伤的发生率,导致过度站立,并延长机械通气的持续时间。自新冠肺炎大流行开始以来,许多没有重症监护经验的临床医生被迫管理需要机械通气的患者。许多学术中心、医院系统和医生团体都试图提供教育材料,为临床医生如何操作呼吸机做好准备。在这段疯狂的时间里,临床医生几乎没有获得任何资源来快速识别在照顾这些患者时出现的呼吸机不同步。本文中给出的数字描述了容积控制通风(VCV)中流量减速斜坡的不同步性,并且是手绘的。虽然它们可能不能完美地代表呼吸机上看到的波形,但下面显示和描述的模式将是相似的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
https://www.journalmechanicalventilation.com/rapid-review-of-patient-ventilator-dyssynchrony/
Patient-Ventilator Dyssynchrony (PVD) is often described as a patient “fighting” the ventilator. In fact, there are many forms of dyssynchrony some of which can very subtle. If unrecognized early, dyssynchrony can evoke patient discomfort, increase incidence of lung injury, lead to oversedation, and lengthen duration of mechanical ventilation. Since start of the COVID-19 pandemic, many clinicians without critical care experience have been compelled to manage patients requiring mechanical ventilation. Many academic centers, hospital systems, and physician groups have attempted to provide educational material in efforts to prepare clinicians on how to operate a ventilator. During this frenzied time, very few resources have been made available to clinicians to rapidly recognize ventilator dyssynchrony as it occurs when taking care of these patients. The figures presented in this article depict dyssynchrony in Volume Control Ventilation (VCV) with a decelerating ramp of flow and are hand drawn. While they may not perfectly represent waveforms seen on ventilators, the patterns shown and described below will be similar.
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