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首页> 外文期刊>Critical care : >Inspiratory oscillatory flow with a portable ventilator: a bench study.
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Inspiratory oscillatory flow with a portable ventilator: a bench study.

机译：便携式呼吸机的吸气振荡流量：台式研究。

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INTRODUCTION: We observed an oscillatory flow while ventilating critically ill patients with the Drager Oxylog 3000 transport ventilator during interhospital transfer. The phenomenon occurred in paediatric patients or in adult patients with severe airway obstruction ventilated in the pressure-regulated or pressure-controlled mode. As this had not been described previously, we conducted a bench study to investigate the phenomenon. METHODS: An Oxylog 3000 intensive care unit ventilator and a Drager Medical Evita-4 NeoFlow intensive care unit ventilator were connected to a Drager Medical LS800 lung simulator. Data were registered by a Datex-S5 Monitor with a D-fend flow and pressure sensor, and were analysed with a laptop using S5-Collect software. Clinical conditions were simulated using various ventilatory modes, using various ventilator settings, using different filters and endotracheal tubes, and by changing the resistance and compliance. Data were recorded for 258 combinations of patient factors and respirator settings to detect thresholds for the occurrence of the phenomenon and methods to overcome it. RESULTS: Under conditions with high resistance in pressure-regulated ventilation with the Oxylog 3000, an oscillatory flow during inspiration produced rapid changes of the airway pressure. The phenomenon resulted in a jerky inspiration with high peak airway pressures, higher than those set on the ventilator. Reducing the inspiratory flow velocity was effective to terminate the phenomenon, but resulted in reduced tidal volumes. CONCLUSION: Oscillatory flow with potentially harmful effects may occur during ventilation with the Drager Oxylog 3000, especially in conditions with high resistance such as small airways in children (endotracheal tube internal diameter <6 mm) or severe obstructive lung diseases or airway diseases in adult patients.
机译：简介：我们在医院间转移期间，在使用Drager Oxylog 3000运输呼吸机为重症患者通风时，观察到振荡的气流。该现象发生在以压力调节或压力控制模式通气的严重气道阻塞的儿科患者或成年患者中。由于以前没有对此进行描述，因此我们进行了一项基准研究以调查此现象。方法：将Oxylog 3000重症监护室呼吸机和Drager Medical Evita-4 NeoFlow重症监护室呼吸机连接到Drager Medical LS800肺部模拟器。数据通过带有D型保险流量和压力传感器的Datex-S5监视器进行记录，并使用S5-Collect软件在笔记本电脑上进行分析。使用各种通气模式，各种通气机设置，不同的过滤器和气管插管，以及通过改变阻力和顺应性来模拟临床情况。记录了258种患者因素和呼吸器设置组合的数据，以检测该现象发生的阈值和解决方法。结果：在使用Oxylog 3000进行压力调节通气的阻力较大的情况下，吸气过程中产生的振荡气流会迅速改变气道压力。这种现象导致呼吸困难，呼吸道的峰值压力高于呼吸机上设定的峰值压力。降低吸气流速可以有效地终止现象，但导致潮气量减少。结论：在使用Drager Oxylog 3000进行通气时，尤其是在儿童气道小（气管导管内径<6 mm）或严重阻塞性肺病或成人气道疾病等高抵抗力的情况下，可能会产生潜在的有害影响的振荡流。

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