气道正压通气下呼吸道气阻与顺应性在线测算方法改进
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1.湖南城市学院 智能呼吸诊疗装备创新基地;2.中国人民解放军总医院 呼吸与危重症医学部;3.中国人民解放军总医院 呼吸与危重症医学部 北京;4.湖南明康中锦医疗科技股份有限公司 研发部 长沙

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Developing the Method for Estimating the Resistance and Compliance in the Airway during Positive Pressure Ventilation
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    摘要:

    背景 呼吸道气阻(Resistance, R)和顺应性(Compliance, C)的有效测算,是实现个体化、精准通气等策略的重要基础之一。目的 在采用气道正压对患者进行通气治疗时,实现对通气患者呼吸道气阻和顺应性的在线测算。方法 为此,当呼气末气流为0时,呼气支持压(expiratory positive airway pressure, EPAP)叠加一个负脉冲气压,使肺内气压在该脉冲期间高于体外气压,向外泄放气流,并对该泄放气流进行处理来测算R和C。然后,以正常成人、典型COPD和ARDS患者为实验对象,建立仿真实验平台,进行仿真实验来测算的R、C。结果 实验得到:所测算正常成人的R和C误差分别为3.398%和-3.288%,COPD患者的R和C误差分别为1.265%和-1.348%,ARDS患者的R和C误差分别为3.400%和-3.286%。结论 实验结果表明,气道正压通气下,采用呼气末叠加一个负脉冲气压在EPAP上来测算R和C的方法具有良好的可行性,该方法的实现将为智能调控通气、精准通气等技术打下坚实的基础。

    Abstract:

    Background The method for estimating the resistance in airway (R) and compliance in lung (C) is one of critical technologies in developing the individualized and precise ventilation. Objective In application of positive airway pressure ventilation, a method was proposed aiming at conducting the method to online estimate the R and C. Method With a negative pulse pressure superposed upon the expiratory positive airway pressure (EPAP), a discharged airflow in the airway was produced, and the R and C were calculated with the discharged airflow. And then, taking the simulated normal adult, typical patients in COPD and in ARDS as the experimental subjects, designing a simulated platform, the simulation experiments were carried out to calculate R and C. Results The errors in the results of R and C respectively are 3.398% and -3.288% for normal adult, 1.265% and -1.348% for patient in COPD, 3.400% and -3.286% for the patient in ARDS. Conclusions The experiments suggested that the method with a negative pulse pressure superposed upon the EPAP to conduct the R and C is well practicable. The investigating in the method will be beneficial for further studying the intelligent and precision ventilation.

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  • 收稿日期:2021-12-27
  • 最后修改日期:2022-01-09
  • 录用日期:2022-01-13
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