重症复杂心脏手术后长期气管插管机械通气的ICU治疗对策

目的 探讨重症复杂心脏手术后长期气管插管呼吸机治疗的ICU治疗对策。方法 对78例经口腔长期气管插管机械通气病人在ICU内呼吸机治疗的机械通气模式、小潮气量加PEEP治疗、镇静剂应用、ICU的常规监测、插管、套囊位置和气囊压力大小的选择进行回顾分析。结果 5例因低心排、肾衰及多器官衰竭而死亡。73例顺利脱机,均痊愈出院。结论 经口腔插管3～10d都是安全的。其中插管及套囊位置、套囊压力是长期气管插管呼吸机治疗的重要环节。小潮气量通气+PEEP+SIMV+压力支持可加强肺保护,有效预防肺不张和肺损伤。

ICU Management of Long-term Endotrachacheal Intubation and Mechanical Ventilation of Patients after Complicated Heart Operations

Objective To discuss the ICU (intensive care unit) measure of long-ierm endotracheai intubadon and to sovorp patients after complicatedheart operations. Methods 78 patients of long-term endotracheai intubation and mechanical ventilation in ICU were retrispectively analyzed, referring to aspects of the mode of mode of mechanical ventilation, remedy of small tidal volume and the pressure in the ballonet Results S patients died of iow heart output,renal failure and multiple organ failure. 73 got rid of respiratory machinessuccessfully, and left the hospital under the condition of healing. Conclusion Endotracheal intubation through mouth is safo during the perioda of 3 -10 days. The locations of endottacheal intubation and the pressure in the ballonet were important aspects It is suggested that the lungs be protected and that pulmonary closure and injure be ented by the steps of small tidal volu me ventilation,prevpositive end-expiratory pressure (PEEP) , synchronized intomittent mandatory ventilation (SIMV) and pressure supports.