侵入性BIPAP-SIMV-PSV在脱机方面的应用

目的：探讨ＢＩＰＡＰ－ＳＩＭＶ－ＰＳＶ在机械通气时的脱机规律。方法：４８例呼吸衰竭患者均采用ＢＩＰＡＰ－ＳＩＭＶ－ＰＳＶ方式脱机，其中１８例由于其它原因脱机失败。成功脱机３０例，分为短期带机（４～１０天）２２例，与长期带机（〉１０天）８例，监测脱机时各参数变化。结果：在吸入氧浓度〈４０＾、低压水平０．３９～０．４９ｋＰａ（１ｋＰａ／１０．２ｃｍＨ２Ｏ）、ＰＳＶ一般在低水平０．４９ｋＰａ，可实施脱机

The Use of Invasive BIPAP-SIMV-PSV in Weaning of Mechanical Ventilation

Objective:To investigate the regularity of BIPAP-SIMV-PSV weaning in mechanical ventilation. Methods:Forty-eight patients with respiratory failure underwent BIPAP-SIMV-PSV weaning. Eighteen of them failed in weaning, and 30 were successful which were divided into short-term(4~10 days,22 cases)and long-term ventilation groups(>10 days,8 cases). Results: The weaning process can be carried out under the condition of FiO2 < 40% , low pressure 0.39 ~ 0.49 kPa, and PSV 0.49 kPa. In short-term ventilation,high pressure generally was adjusted less than 1.57 kpa,and the gap between high and low pressure was 0.49~ 1.17 kPa. In some patients with severe lung dysfunction, high pressure was almost equal to low pressure 0.49 kPa for the purpose of successfully completing ventilation. The respiratory frequency was 4 breathes/min, and I:E was 1:4 in two groups.There was no significant difference in weaning between two groups(P>0.05). Conclusion:BI-PAP-SIMV-PSV is a better method for patients with difficult weaning.