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目的：探讨采用吸气压力支持（ＩＰＳ）通气时压力支持（ＰＳ）水平与潮气量（ＶＴ）、呼吸频率（ｆ）、闭合压（Ｐ０．１）和血气分析（ＢＧＡ）的关系，以及如何选择适宜的ＰＳ水平成功地预测脱机的方法。方法：采用对照研究的方法将３４例机械通气患者按最终是否经ＩＰＳ脱机成功分为２组：脱机成功组２５例，ＡＰＡＣＨＥⅡ记分平均（２５．４±５．４）分；脱机失败组９例，ＡＰＡＣＨＥⅡ记分平均（３０．２±５．２）分。每８小时或改变ＰＳ水平后记录ＶＴ、ｆ、Ｐ０．１、经皮氧饱和度（ＳｐＯ２），每日查ＢＧＡ。结果：ＩＰＳ脱机成功率７４％（２５／３４）。脱机时ＰＳ＜０．６９ｋＰａ（１ｋＰａ＝１０．２０ｃｍＨ２Ｏ），Ｐ０．１＜０．３９ｋＰａ。机械通气＜１４日者，用ＩＰＳ０．５～２日后结合常规参数指标很容易脱机；超过１４日带机者，用ＩＰＳ３～７日可脱机，脱机指标除常规参数外还应结合Ｐ０．１的动态观察，ＰＳ常需降至０．３９～０．５９ｋＰａ，结合ｆ、Ｐ０．１及ＶＴ调整ＰＳ水平。结论：ＩＰＳ作为患者触发呼吸机的一种辅助通气方式，结合Ｐ０．１监测能提供最佳ＰＳ水平，并能较早地成功预测脱机。
PURPOSE: To investigate the relationship between pressure support (PS) and tidal volume (VT), respiratory rate (f), closure pressure (P.1) and blood gas analysis (BGA) during ventilated ventilated support (IPS) Choose the appropriate PS level to successfully predict the offline method. Methods: A total of 34 patients with mechanical ventilation were divided into two groups according to whether they were successfully treated with IPS or not: 25 patients in the successful off-line group and 25.4 ± 5.4 in the APACHE II score; Group 9 cases, APACHE Ⅱ score average (30.2 ± 5.2) points. Record VT, f, P0.1, and percutaneous oxygen saturation (SpO2) every 8 hours or after changing PS levels, and check BGA daily. Results: The success rate of IPS off-line was 74% (25/34). Off-line PS <0.69kPa (1kPa = 10.20cmH2O), P0.1 <0.39kPa. Mechanical ventilation <14, with IPS0.5 ~ 2 days after the index with conventional parameters is easy to offline; with more than 14 days with the machine, with IPS3 ~ 7th can be offline, offline indicators in addition to conventional parameters should be combined with P0 .1 dynamic observation, PS often need to drop to 0.39 ~ 0.59kPa, combined with f, P0.1 and VT adjust the PS level. CONCLUSIONS: IPS, as an adjunct ventilator for triggering a ventilator in patients, provides the best PS level combined with P0.1 monitoring and enables early, successful offline prediction.