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首页> 外文期刊>Intensive care medicine >Continuous flow biphasic positive airway pressure by helmet in patients with acute hypoxic respiratory failure: effect on oxygenation.
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Continuous flow biphasic positive airway pressure by helmet in patients with acute hypoxic respiratory failure: effect on oxygenation.

机译：急性低氧性呼吸衰竭患者通过头盔持续产生双相气道正压通气：对氧合作用的影响。

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PURPOSE: We investigated the effects of periodical high pressure breaths (SIGH) or biphasic positive pressure ventilation (BIPAP) during helmet continuous positive airway pressure (CPAP) in patients with acute hypoxic respiratory failure. METHODS: We used a recently developed electromechanical expiratory valve (TwinPAP, StarMed, Mirandola, Italy), which is time-cycled between two customizable positive end-expiratory pressure (PEEP) levels. We studied 21 patients (67 +/- 17 years old) undergoing helmet CPAP. Continuous flow CPAP system was set at 60 l/min flow rate while maintaining clinical FiO(2) (51 +/- 15%). Five steps, lasting 1 h each, were applied: (1) spontaneous breathing with PEEP 0 cmH(2)O (SB), (2) CPAP with PEEP 8 cmH(2)O (CPAP(basal)), (3) low PEEP, 8 cmH(2)O, for 25 s and high PEEP, 25 cmH(2)O, for 5 s (SIGH), (4) low PEEP, 8 cmH(2)O, for 3 s and high PEEP, 20 cmH(2)O, for 3 s (BIPAP), (5) CPAP with PEEP 8 cmH(2)O (CPAP(final)). We randomized the sequence of SIGH and BIPAP. RESULTS: PaO(2) was significantly higher during all steps compared to SB. When compared to CPAP(basal), both SIGH and BIPAP induced a further increase in PaO(2). PaO(2) during SIGH and BIPAP were not different. The oxygenation improvement was maintained during CPAP(final). CONCLUSIONS: Superimposed, nonsynchronized positive pressure breaths delivered during helmet CPAP by means of the TwinPAP system may improve oxygenation in patients with acute hypoxemic respiratory failure, even at a rate as low as two breaths per minute.
机译：目的：我们研究了在急性低氧性呼吸衰竭患者中，持续高压呼吸（SIGH）或双相正压通气（BIPAP）在头盔持续气道正压通气（CPAP）中的作用。方法：我们使用了最新开发的电动机械式呼气阀（TwinPAP，StarMed，米兰达拉，意大利），该阀在两个可定制的呼气末正压（PEEP）水平之间进行时间循环。我们研究了21例接受头盔CPAP的患者（67 +/- 17岁）。连续流量CPAP系统设置为60 l / min流量，同时保持临床FiO（2）（51 +/- 15％）。进行五个步骤，每个步骤持续1小时：（1）PEEP 0 cmH（2）O（SB）的自发呼吸，（2）PEEP 8 cmH（2）O（CPAP（basal））的CPAP，（3）低PEEP，8 cmH（2）O，持续25 s和高PEEP，25 cmH（2）O，持续5 s（SIGH），（4）低PEEP，8 cmH（2）O，持续3 s和高PEEP ，20 cmH（2）O，持续3 s（BIPAP），（5）CPAP与PEEP 8 cmH（2）O（CPAP（final））。我们随机化了SIGH和BIPAP的序列。结果：PaO（2）在所有步骤中均显着高于SB。与CPAP（基础）相比，SIGH和BIPAP均引起PaO（2）进一步增加。 SIGH和BIPAP期间的PaO（2）相同。在CPAP（最终）期间维持了氧合改善。结论：在头盔CPAP期间通过TwinPAP系统进行的叠加，不同步的正压呼吸可能会改善急性低氧血症性呼吸衰竭患者的氧合作用，即使呼吸频率每分钟低至两次。

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