额外补氧对无创呼吸机监测潮气量的影响研究  

Study on the Effect of Additional Oxygen Supplementation on Tidal Volume Monitored by Non-Invasive Ventilator

作　　者：唐永林[1] TANG Yonglin(Second Ward,Intensive Care Unit,The Second Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150086,China)

机构地区：[1]哈尔滨医科大学附属第二临床医学院重症医学科二病房,黑龙江哈尔滨150086

出　　处：《中国医疗设备》2022年第12期58-62,68,共6页China Medical Devices

摘　　要：目的探讨补氧部位、补氧流量以及呼气阀对无创呼吸机监测潮气量的影响,指导临床应用无创通气时选择最佳的补氧方案和呼气阀。方法模拟临床无创通气,在此基础上分别在面罩上、呼气阀后和呼吸机出气口给予补充氧气,测量潮气量和氧浓度参数,并进行分析。结果相同条件(Inspiratory Positive Airway Pressure,IPAP:18 cmH2O;Exhale Positive Airway Pressure,EPAP:6 cmH_(2)O)下,不同呼气阀(平台阀、静音阀、侧孔阀)间对潮气量存在影响(P<0.05)。应用静音阀、平台阀、侧孔阀时补氧部位在测压点前补充氧气,测定的潮气量均较测压点后高。相同条件下补氧部位在面罩上补充氧气,测定的氧浓度高于呼吸阀后和呼吸机出气口的氧浓度;无创通气应用侧孔阀时测定的氧浓度高于平台阀和静音阀。无创通气应用平台阀时,平台阀采用出口端端口补充氧气,测定的氧浓度高于入口端端口。结论无创机械通气时,相同条件下不同类型呼气阀之间的潮气量、氧浓度存在差异;随着补充氧流量增大,测定的潮气量呈下降趋势。研究结果为临床选择合适的呼气阀和补氧方案提供了方向。Objective To investigate the effect of oxygen supplement position,oxygen flow rate and expiratory valve on non-invasive ventilator monitoring tidal volume and explore the best oxygen supplement program and expiratory valve for non-invasive ventilation.Methods By simulating clinical non-invasive ventilation,we gave supplemental oxygen on the mask,behind the exhalation valve,and at the outlet of the ventilator.Then,we measured and compared the parameter values of tidal volume and oxygen concentration.Results We found that under the same conditions(inspiratory positive airway pressure,IPAP:18 cmH2O;exhale positive airway pressure,EPAP:6 cmH2O),different exhalation valves(platform valve,silent valve,side hole valve)had different impact on tidal volume(P<0.05).When silent valve,platform valve and side hole valve were used,oxygen was supplied to the oxygen supply position before the pressure measuring point,and the measured tidal volume was higher than that after the pressure measuring point.The oxygen supplement part replenished oxygen on the mask,and the measured oxygen concentration was higher than the oxygen concentration behind the breathing valve and at the ventilator outlet.The oxygen concentration measured when using side hole valve for non-invasive ventilation was higher than that of platform valve and mute valve.When the platform valve was used for non-invasive ventilation,the outlet port of the platform valve was used to supplement oxygen,and the measured oxygen concentration was higher than that of the inlet port.Conclusion During non-invasive mechanical ventilation,there are differences in tidal volume and oxygen concentration between different types of expiratory valves under the same conditions.With the increase of supplemental oxygen flow,the measured tidal volume shows a downward trend.The results of this study provide a direction for the clinical selection of appropriate exhalation valve and oxygen supplement scheme.

关 键 词：无创通气 无创呼吸机 潮气量 额外补氧 氧浓度 

分 类 号：R197.39[医药卫生—卫生事业管理]