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目的探讨压力支持通气(pressure support ventilation,PSV)模式下呼气触发灵敏度(expiratorytrigger sensitivity,ETS)对慢性阻塞性肺疾病(chronic obstructive ppulmonary disease,COPD)患者潮气量(tidalvolume,Vt)、呼吸频率(respiratory rate,RR)、吸气时间(inspiratory time,Ti)、口腔阻断压(mouth occlusionpressure,P0.1)、浅快呼吸指数(rapid shallow breathing index,RSB)及有效吸气阻抗(inspiratory impedance,P0.1/Vt/Ti)的影响,揭示ETS对呼吸效率的影响。方法选取2006年12月 2008年1月收入呼吸内科重症监护室的COPD急性加重期合并呼吸衰竭行有创机械通气患者31例,行气管插管或气管切开接伽利略金型呼吸机。病情稳定后采用PSV模式,在其他参数不变的情况下随机调整ETS%水平于5%、35%、65%,通气30～60 min后测量Vt、RR、Ti及P0.1,并计算RSB和P0.1/Vt/Ti。应用自身对照的方法对不同ETS%水平下各参数进行比较。结果随着ETS%水平增加,Vt和Ti减少(P<0.05),RR、RSB及P0.1/Vt/Ti增加(P <0.05),差异均有统计学意义。P0.1在ETS 35%水平较低,但在ETS 5%与ETS 35%比较差异无统计学意义(P>0.05)。结论在PSV模式下随ETS%水平增加COPD患者的呼吸效率降低。
Objective To investigate the influence of expiratorytrigger sensitivity (ETS) on tidal volume (Vt) and respiratory rate (COPD) in patients with chronic obstructive pulmonary disease (COPD) under pressure support ventilation (PSV) respiratory rate (RR), inspiratory time (Ti), mouth occlusion pressure (P0.1), rapid shallow breathing index (RSB) and inspiratory impedance P0.1 / Vt / Ti) to reveal the impact of ETS on respiratory efficiency. Methods Totally 31 patients with invasive mechanical ventilation were enrolled in this study from December 2006 to January 2006 with respiratory surgical intensive care unit in acute exacerbation of chronic obstructive pulmonary disease (COPD). Patients underwent mechanical ventilation or tracheotomy with Galileo Ventilator. PSV mode was adopted after the disease was stable, and the Vt, RR, Ti and P0.1 were measured by adjusting the ETS% level at 5%, 35%, 65% and ventilated for 30-60 minutes with the other parameters unchanged. The RSV And P0.1 / Vt / Ti. The self-control method was used to compare the parameters under different ETS% levels. Results With the increase of ETS%, Vt and Ti decreased (P <0.05), RR, RSB and P0.1 / Vt / Ti increased (P <0.05), the differences were statistically significant. P0.1 was lower at 35% of ETS but not statistically significant at ETS 5% vs ETS 35% (P> 0.05). Conclusions The respiratory efficiency of COPD patients decreases with increasing ETS% in PSV mode.