无创气道正压通气下呼气末测算气道阻力和胸肺顺应性实验研究
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国家重点研发计划项目(2021YFC0122500),国家级大学生创新训练项目(S202311527084)


Calculating Airway Resistance and Lung Compliance at Expiration End under Non-invasive Positive Pressure Ventilation: An Experimental Study
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    摘要:

    目的 采用呼气末压力短暂释放的方式,测算无创正压通气(non-invasive positive pressure ventilation, NPPV)条件下的气道阻力(R)和胸肺顺应性(C),并评估其测算精度。方法 首先,将测算方法程序移植到NPPV呼吸机的控制器,设计基于主动模拟肺ASL5000的通气实验平台。然后,模拟正常成人(R=5 cmH2O,C=50 mL/cmH2O)、急性呼吸窘迫综合征成人患者(R=10 cmH2O,C=30 mL/cmH2O)和慢性阻塞性肺疾病成人患者(R=20 cmH2O,C=50 mL/cmH2O)的R和C进行实验。结果 测算所得R最大相对误差达到-12.67%,出现在对正常成人的测定;C最大相对误差达到17.37%,出现在对急性呼吸窘迫综合征成人患者的测定。采用均值配对双样本t检验法对每组测试数据进行分析,差异没有统计学意义(P> 0.05)。结论 实验所得R、C与在ASL5000上的设置值相一致。NPPV下呼气末R、C的测算方法具有良好的可行性,其实现与应用有助于呼吸机通气治疗的精准化和个体化。

    Abstract:

    Objective Airway resistance (R) and lung compliance (C) under non-invasive positive pressure ventilation (NPPV) conditions were measured using a brief pressure release at the end of expiration, and the measurement accuracy was also evaluated. Methods An NPPV respirator was developed by programming a method for calculating R and C. An experimental platform based on the active servo lung ASL5000 was designed. By simulating a healthy adult (R=5 cmH2O and C=50 mL/cmH2O), an adult patient with acute respiratory distress syndrome (R=10 cmH2O and C=30 mL/cmH2O), and an adult patient with chronic obstructive pulmonary disease (R=20 cmH2O and C=50 mL/cmH2O), a series of experiments for calculating the R and C were conducted. Results The maximum relative error of R was -12.67%, which occurred in calculating the R of an average adult. The maximum relative error of C was 17.37%, which occurred when calculating the C values of patients with acute respiratory distress syndrome. Each group of data was analyzed using a paired t-test, which showed statistically significant differences (P>0.05). Conclusions The calculation method for R and C at the end of expiration during NPPV is feasible, and its realization and application will be beneficial for achieving precise and personalized respiratory ventilation.

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袁越阳,解立新,陈宇清,胡兴硕,黄皓轩,李立雄,徐强.无创气道正压通气下呼气末测算气道阻力和胸肺顺应性实验研究[J].医用生物力学,2024,39(4):750-755

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  • 收稿日期:2023-10-01
  • 最后修改日期:2023-11-02
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  • 在线发布日期: 2024-08-26
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