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呼吸驱动和吸气努力的监测与评价

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肺-膈肌保护性通气旨在限制危重症患者在机械通气过程中肺和膈肌的副损伤.其中呼吸驱动和吸气努力的动态监测是临床实施肺-膈肌保护性通气的重点.本文按照呼吸驱动的生理路径,自上而下的在呼吸肌、压力变化和肺通气三个层面对现有的呼吸驱动和吸气努力的监测指标进行综述,分别对其意义、获得方式、相应界值以及优缺点逐一进行讨论.
Dynamic monitoring of respiratory drive and inspiratory effort
Lung-diaphragmatic protective ventilation aims to limit damage to the lung and diaphragm during mechanical ventilation in critically ill patients.The dynamic monitoring of respiratory drive and inspiratory effort is the focus of the clinical strategies for implementating lung-diaphragm protective ventilation strategies.This paper reviews the existing indicators for dynamic monitoring of respiratory drive and inspiratory effort at the three levels of respiratory muscle,pressure change,and pulmonary ventilation according to the physiological pathway of respiratory drive and discusses their significance,acquisition methods,and thresholds.

respiratory driveinspiratory effortprotective ventilation

高然、周建新

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首都医科大学附属北京天坛医院重症医学科,北京 100070

首都医科大学附属北京世纪坛医院急救与重症医学中心 急性肺损伤临床与研究中心,北京 100038

呼吸驱动 吸气努力 保护性通气

首都卫生发展科研专项首都医科大学临床与研究中心项目

首发 2024-1-2081CMU-2023-45

2024

首都医科大学学报
首都医科大学

首都医科大学学报

CSTPCD北大核心
影响因子:1.511
ISSN:1006-7795
年,卷(期):2024.45(2)
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