高流量经鼻氧疗影响呼吸窘迫综合症患者呼吸力学参数的实验研究
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1.湖南城市学院 智能呼吸诊疗装备产学研创新基地 湖南益阳;2.中国人民解放军总医院 呼吸内科 北京;3.湖南明康中锦医疗科技发展有限公司 长沙

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R

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Experiment-Based Investigate the Changed Respiratory Mechanical Parameters of the Patient in Aute Respiratory Distress Syndrome under High Flow Nasal Cannula
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    摘要:

    目的 基于通气实验,分析高流量经鼻氧疗(HFNC)流量对呼吸窘迫综合征(ARDS)患者的呼吸力学参数的影响,探讨HFNC对ARDS患者的通气效果和副作用。 方法 为此,分别设计基于Matlab的HFNC通气系统模型和基于主动模拟肺ASL5000的物理实验平台,模拟不同肺顺应的ARDS患者呼吸运动,进行HFNC通气实验,并将两者实验结果进行比较分析。 结果 基于Matlab模型的仿真实验和基于物理平台的物理实验结果一致表明:增大HFNC的通气流量,将减小患者的呼吸气流流量(Q)、潮气量(Vt),提高患者肺内压(Plung)、功能残气量(FRC)等。在实验中,HFNC所提供的气流有时低于患者呼吸道内的吸气气流,从而需要得到一定的吸气补偿气流来满足患者吸气需求。 结论 因而,采用HFNC对ARDS患者通气时,随着通气流量的增加,Q和Vt趋于减小,而Plung和FRC趋于增大。充分的吸气补偿气流来填补HFNC所提供气流的不足是通气安全的保障措施之一。明确HFNC下ARDS患者呼吸力学参数的变化将有助于采取通气措施,提高通气疗效,降低通气风险。

    Abstract:

    Objective Model-based virtual experiments with different output flows delivered by high flow nasal cannula (HFNC), the respiratory mechanical parameters of the patient in acute respiratory distress syndrome (ARDS) would be investigated for discussing the therapeutic and side effects of the HFNC. Method Consequently, with using the Matlab, a ventilation system model of HFNC including the sub-model of HFNC device and sub-model of respiratory patient in ARDS was developed for simulation experiments. In the experiments, the ARDS patient with different lung compliances was set. The ventilations of HFNC were carried out for collecting and analyzing the data of respiratory mechanical parameters. And the simulation-based outcomes were discussed comparing to the outcomes get in physical experiments. Results The experiments illustrated: Increasing the output flow of HFNC, the relevant respiratory mechanical parameters of respiratory flow (Q) and tidal volume (Vt) will be tendentiously decreased, but the intrapulmonary pressure (Plung) and the functional residual capacity (FRC) will be increased; At the condition of small flow, the output flow from HFNC may be smaller than the inspiratory airflow required by the patient. Conclusions Summarily, under treatment with the HFNC applied in ARDS patient, increasing the output flow of HFNC will tendentiously reduce the Q and Vt, but rise the Plung and FRC. The necessary compensation in inspiration to make up for a lack of gas will promote the security of HFNC. Understanding the changing in the respiratory mechanical parameters of ARDS patient will be beneficial to pre-evaluate the HFNC, to improve the treatment effect of HFNC, and to reduce the risks of HFNC.

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  • 收稿日期:2021-08-31
  • 最后修改日期:2021-09-30
  • 录用日期:2021-10-11
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