高流量经鼻氧疗影响呼吸窘迫综合征患者呼吸力学参数的实验研究
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湖南省自然科学基金项目(2020JJ4159),科技部“数字诊疗装备研发”重点专项项目(2021YFC0122500)


Experimental Study on Respiratory Mechanical Parameters of the Patient with Aute Respiratory Distress Syndrome under High Flow Nasal Cannula
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    摘要:

    目的 基于通气实验,分析高流量经鼻氧疗(high flow nasal cannula,HFNC)流量对呼吸窘迫综合征(acute respiratory distress syndrom,ARDS)患者呼吸力学参数的影响,探讨HFNC对ARDS患者的通气效果和副作用。方法 分别设计基于Matlab的HFNC通气系统模型和基于主动模拟肺ASL5000的物理实验平台,模拟不同肺顺应的ARDS患者呼吸运动,进行HFNC通气实验,并将两者实验结果进行比较分析。结果 基于Matlab模型的仿真实验和基于物理平台的物理实验结果一致表明,增大HFNC的通气流量,将减小患者的呼吸气流流量、潮气量,提高患者肺内压、功能残气量等。在实验中,HFNC所提供的气流有时低于患者呼吸道内的吸气气流,从而需要得到一定的吸气补偿气流来满足患者吸气需求。结论 充分的吸气补偿气流来填补HFNC所提供气流不足是通气安全的保障措施之一。明确HFNC下ARDS患者呼吸力学参数的变化将有助于采取通气措施,提高通气疗效,降低通气风险。

    Abstract:

    Objective T o analyze the influence of high flow nasal cannula (HFNC) on trespiratory mechanical parameters of the patient with acute respiratory distress syndrome (ARDS) based on ventilation experiment, and investigate the therapeutic and side effects of the HFNC. Methods The HFNC ventilation system model based on MATLAB and the physical experiment platform based on active simulated lung ASL5000 were developed to simulate the respiratory movement of ARDS patients with different lung compliance, and a series of the HFNC ventilation experiments were carried out. Both experimental results in MATLAB and physical platform were compared and analyzed. Results The results from the Matlab model-based simulation experiment and physical platform based-physical experiment uniformly showed that increasing the output flow of HFNC would decrease the relevant respiratory mechanical parameters of respiratory flow and tidal volume, but increase the intrapulmonary pressure and the functional residual capacity (FRC). Under the condition of small flow, the output flow from HFNC might be smaller than the inspiratory flow required by the patient, and an inspiratory compensation flow was necessary to make up for the inspiratory flow. Conclusions The necessary reliable compensation flow in inspiration will promote the security of HFNC. Understanding the changes in respiratory mechanical parameters of ARDS patient will be beneficial to pre-evaluate the HFNC, improve the ventilation effect and reduce the ventilation risks.

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袁越阳,周理,胡兴硕,黄皓轩,何超.高流量经鼻氧疗影响呼吸窘迫综合征患者呼吸力学参数的实验研究[J].医用生物力学,2022,37(4):650-656

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  • 收稿日期:2021-08-31
  • 最后修改日期:2021-09-24
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  • 在线发布日期: 2022-08-25
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