呼吸机非正常脱机方式在EICU的应用探讨  

Abnormal breathing machine off-line application in the EICU

作　　者：李泓[1] 张中[2] 李纯[1] 莫岚[3] 

机构地区：[1]北京丰台医院急诊科,100071 [2]北京丰台医院呼吸科,100071 [3]北京丰台医院危重症科,100071

出　　处：《中国急救复苏与灾害医学杂志》2012年第3期236-237,255,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨在EICU中改进传统阶梯撤机的方法，及非正常方式脱机进行撤机方法的尝试。方法对26例EICU收治的机械通气维持呼吸功能的重症患者，给予非正常方式脱机方法进行撤机观察其撤机成功的效果。结果本组26例患者中，成功撤机患者恢复完全自主呼吸16例，占61．5％，间断面罩吸氧3例占11．6％，间断无创呼吸机辅助呼吸3例占11．5％，脱机失败复上机后，无法脱机者4例占15．3％脱机失败者其中3例为呼吸机无力的患者为侧索硬化1例，重症肌无力1例，小血管炎合并肺纤维化1例（此患者死于上消化道出血）。结论在同步间歇指令通气＋压力支持通气模式下不经过试脱机，直接拔除气管插管脱机方式适用于大部分EICU危重症机械通气的患者，其具有缩短上机时间抓住脱机时机，脱机成功率高，减轻患者痛苦的特点。Objective To improve the traditional ladder in EICU the weaning method, and non-normal way of weaning off approach to try. Methods 26 patients were treated with mechanical ventilation to maintain EICU respiratory function of critically ill patients given non-normal way of weaning off method to observe the effect of successful weaning. Results The 26 patients in weaning patients recover completely spontaneous breathing in 16 cases, accounting for 61.5%, 3 cases of intermittent oxygen masks 11.6%, intermittent non-invasive mechanical ventilation 3 11.5%, which failed on the off-line machine, you can not offline in 4 cases, 15.3% 3 of them were off-line failure inability of the patients were ventilator lateral sclerosis in 1 case, 1 case of myasthenia gravis, vaseulitis with pulmonary fibrosis in 1 case （this patient died of upper gastrointestinal bleeding.） Conclusion SIMV ＋ PSV through a trial offline mode does not directly extubation offline for most critically ill patients mechanically ventilated ICU patients, with reduced off-line eomputer time to seize the opportunity to offline success rate to alleviate the pain characteristics of patients, it can be further applied in EICU

关 键 词：呼吸机脱机 非正常机脱机 

分 类 号：R459.7[医药卫生—急诊医学]