浙江医学2017，Vol.39Issue(15)：1274-1276,1279,4.DOI:10.12056/j.issn.1006-2785.2017.39.15.2017-501
神经调节辅助通气在AECOPD患者序贯治疗中的应用
Application of neurally adjusted ventilatory assist (NAVA) in sequential mechanical ventilation for patient with AECOPD
摘要
Abstract
Objective To assess the application of neurally adjusted ventilatory assist (NAVA) in sequential mechanical ventilation for patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).Methods Twenty-eight AECOPD patients receiving mechanical ventilation in ICU were randomly divided into pressure support ventilation (PSV) group (n=15) and NAVA group (n=13).When pulmonary infection control (PIC) window appeared,the PSV converted to non-invasive ventilation(NIV)-PSV and the NAVA converted to NIV-NAVA with noninvasive sequential mechanical ventilation.The arterial blood gas,the time of noninvasive sequential mechanical ventilation,reintubation rate in 48 h and the length of ICU stay were documented and compared between two groups.Results The breathing rate,heart rate and effect of gas exchange were improved after mechanical ventilation in both groups.Compared with PSV,NAVA had shorter time for reaching PIC window (92.62 ± 7.61 h vs.101.40 ± 12.88 h,P＜0.05).The time of noninvasive sequential mechanical ventilation on NIV-NAVA were shorter (72.46 ± 11.95h vs.81.87h ± 11.10,P＜0.05),and the length of ICU stay was shorter than NIV-PSV (7.57 ± 2.66d vs 10.30 ± 4.03d,P＜0.05)in noninvasive sequential mechanical ventilation.Compared with NIV-PSV,reintubation rate within 48h in NIV-NAVA had a lower trend,but there was no significant difference between two groups (P ＞0.05).Conclusion NAVA has a short time of PIC window appearing and invasive ventilation,and also a shorter duration of noninvasive sequential mechanical ventilation and shorter length of ICU stay than PSV for AECOPD patients.关键词
慢性阻塞性肺疾病急性加重/序贯机械通气/肺部感染控制窗/神经调节辅助通气Key words
Acute exacerbation of chronic obstructive pulmonary disease/Sequential mechanical ventilation/Pulmonary infection control window/Neurally adjusted ventilatory assist引用本文复制引用
王丹琼,张伟文,罗建,熊晓华,祝利华,方红龙,胡建华,吴华勇..神经调节辅助通气在AECOPD患者序贯治疗中的应用[J].浙江医学,2017,39(15):1274-1276,1279,4.基金项目
浙江省科技厅基金项目(2014C33250) （2014C33250）
