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Differential Effects of Endotracheal Suctioning on Gas Exchanges in Patients with Acute Respiratory Failure under Pressure-Controlled and Volume-Controlled Ventilation

机译:压力控制和容积控制通气下气管内吸气对急性呼吸衰竭患者气体交换的不同作用

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摘要

This study was conducted to evaluate the effects of open endotracheal suctioning on gas exchange and respiratory mechanics in ARF patients under the modes of PCV or VCV. Ninety-six ARF patients were treated with open endotracheal suctioning and their variations in respiratory mechanics and gas exchange after the suctions were compared. Under PCV mode, compared with the initial level of tidal volume (V T), ARF patients showed 30.0% and 27.8% decrease at 1 min and 10 min, respectively. Furthermore, the initial respiratory system compliance (C rs) decreased by 29.6% and 28.5% at 1 min and 10 min, respectively. Under VCV mode, compared with the initial level, 38.6% and 37.5% increase in peak airway pressure (PAP) were found at 1 min and 10 min, respectively. Under PCV mode, the initial PaO2 increased by 6.4% and 10.2 % at 3 min and 10 min, respectively, while 18.9% and 30.6% increase of the initial PaO2 were observed under VCV mode. Summarily, endotracheal suctioning may impair gas exchange and decrease lung compliance in ARF patients receiving mechanical ventilation under both PCV and VCV modes, but endotracheal suctioning effects on gas exchange were more severe and longer-lasting under PCV mode than VCV.
机译:本研究旨在评估在PCV或VCV模式下,气管内开放吸引对ARF患者的气体交换和呼吸力学的影响。对96例ARF患者进行了开放气管内抽吸治疗,比较了抽吸后呼吸力学和气体交换的变化。在PCV模式下,与初始潮气量(V T)相比,ARF患者在1分钟和10分钟时分别下降30.0%和27.8%。此外,在1分钟和10分钟时,初始呼吸系统顺应性(C rs)分别降低了29.6%和28.5%。在VCV模式下,与初始水平相比,在1分钟和10分钟时,气道峰值压力(PAP)分别增加了38.6%和37.5%。在PCV模式下,初始PaO2在3分钟和10分钟时分别增加了6.4%和10.2%,而在VCV模式下,初始PaO2分别增加了18.9%和30.6%。综上所述,在PCV和VCV模式下接受机械通气的ARF患者,气管内抽吸可能会损害气体交换并降低肺顺应性,但PCV模式下气管内抽吸对气体交换的影响比VCV更为严重且持续时间更长。

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