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床旁死腔通气监测在危重症患者中的应用

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死腔是指通气过程中由于不与肺毛细血管血液接触而不能参与气体交换的部分。死腔通气是影响通气效率的主要原因。死腔分数、通气比和呼气末二氧化碳分压/动脉血二氧化碳分压等是监测死腔通气的常用指标。床旁死腔通气监测在急性呼吸窘迫综合征、肺栓塞和外科手术等患者中应用广泛,具有诊断疾病、预测预后和评估治疗效果的作用。本文将对这些指标及其临床应用进行详细阐述,希望引起医务人员对死腔通气监测的重视,规范其临床操作和应用。 Dead space refers to the volume of ventilated air that cannot participate in gas exchange because of the non-contact with the blood of pulmonary capillaries.Dead space ventilation is the main reason cause influencing ventilation efficiency.Dead-space fraction, ventilatory ratio and end-tidal-to-arterial partial pressure of carbon dioxide ratio are common indexes for measuring dead space ventilation.Dead space ventilation measurement is widely used in patients with acute respiratory distress syndrome, pulmonary embolism and surgery, presenting the diagnostic, prognostic and predictive potentials on the therapeutic efficacy.This article thoroughly described these indicators and their clinical applications, aiming to highlight dead space ventilation monitoring by medical staff and standardize its clinical operations and applications.
Application of bedside measurements of dead space ventilation in critically ill patients
Dead space refers to the volume of ventilated air that cannot participate in gas exchange because of the non-contact with the blood of pulmonary capillaries.Dead space ventilation is the main reason cause influencing ventilation efficiency.Dead-space fraction, ventilatory ratio and end-tidal-to-arterial partial pressure of carbon dioxide ratio are common indexes for measuring dead space ventilation.Dead space ventilation measurement is widely used in patients with acute respiratory distress syndrome, pulmonary embolism and surgery, presenting the diagnostic, prognostic and predictive potentials on the therapeutic efficacy.This article thoroughly described these indicators and their clinical applications, aiming to highlight dead space ventilation monitoring by medical staff and standardize its clinical operations and applications.

Respiratory distress syndromePulmonary embolismDead space ventilationDead space fractionVentilatory ratioVolumetric capnography

陶程、夏金根、段思琦

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国家呼吸医学中心 呼吸和共病全国重点实验室 国家呼吸疾病临床研究中心 中国医学科学院呼吸病学研究院 中日友好医院呼吸与危重症医学科,北京 100029

呼吸窘迫综合征 肺栓塞 死腔通气 死腔分数 通气比 容积二氧化碳图

国家重点研发计划

2022YFC2504401

2024

国际呼吸杂志
中华医学会 河北医科大学

国际呼吸杂志

CSTPCD
影响因子:0.55
ISSN:1673-436X
年,卷(期):2024.44(1)
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