神经调节通气辅助模式：困难撤机的新探索  

Neurally adjusted ventilatory assist： a new exploration for difficult weaning

作　　者：钟雪锋[1] 谭政[1] 居阳[1] 李毅[1] 陈静[1] 李燕明[1] Zhong Xuefeng;Tan Zheng;Ju Yang;Li Yi;Chen Jing;Li Yanming.(Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, National Clinical Research Center for Respiratory Diseases, Beijing 100730, China)

机构地区：[1]北京医院呼吸与危重医学科国家老年医学研究中心国家呼吸临床研究中心,100730

出　　处：《国际呼吸杂志》2018年第12期928-932,共5页International Journal of Respiration

摘　　要：目的探讨神经调节通气辅助模式（NAVA）在困难撤机的价值。方法通过分析1例使用NAVA撤离呼吸机的过程,探讨NAVA在困难撤机中的作用,并结合相关文献进行讨论。结果患者脑出血后长期上呼吸机,脱机失败,换用NAVA后,通过测定膈肌动作电位,来评估患者膈肌功能,并使用NAVA进行呼吸功能锻炼,最终成功脱机。结论NAVA是一种较理想的接近生理通气模式,同时可以评估膈肌的功能,在困难撤机上有好的应用前景。Objective To investigate the value of Neurally adjusted ventilatory assist mode （NAVA） in difficult weaning. Methods Discussed the value of NAVA in the difficult weaning by analyzing the weaning process using the NAVA model in one case, and then reviewed related literatures. Results The patient underwent a long-term mechanical ventilation and failure of weaning after intracerebral hemorrhage. The diaphragm function was evaluated by measuring diaphragm electrical action potential and gradually exercised after switching to NAVA mode. Finally weaning successed. Conclusions NAVA is an idealventilation mode close to physiologicaland at the same time to evaluate the function of diaphragm. It has a good application prospect in difficult weaning.

关 键 词：神经调节通气辅助 膈肌动作电位 困难撤机 

分 类 号：R459.7[医药卫生—急诊医学]