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目的:探讨BIPAP-SIMV-PSV在机械通气时的脱机规律。方法:48例呼吸衰竭患者均采用BIPAP-SIMV-PSV方式脱机,其中18例由于其它原因脱机失败。成功脱机30例,分为短期带机(4～10天)22例,与长期带机(>10天)8例,监测脱机时各参数变化。结果:在吸入氧浓度<40%、低压水平0.39～0.49 kPa(1 kPa=10.2cmH_2O)、PSV一般在低压水平0.49 kPa,可实施脱机过程。短期带机一般使高压水平减至≤1.57 kPa,长期带机高压水平0.98～1.17 kPa,高-低压水平差0.49～1.17 kPa,部分重度肺功能损害患者往往需高压水平接近于低压水平=0.49 kPa完成脱机过程。两组设定呼吸频率4次/分,吸呼比为1:4,两组脱机参数无明显变化(P>0.05)。结论:BIPAP-SIMV-PSV对难以脱机的患者是一种较好的脱机方式。
Objective: To investigate the off-line pattern of BIPAP-SIMV-PSV during mechanical ventilation. Methods: All 48 patients with respiratory failure were treated with BIPAP-SIMV-PSV. 18 patients failed to go offline for other reasons. Thirty patients were successfully off-line, divided into short-term (4 to 10 days) in 22 cases, and long-term with (> 10 days) in 8 cases. Results: The PSV was generally 0.49 kPa at a low pressure level of 0.49 to 0.49 kPa (1 kPa = 10.2 cmH 2 O) at an inspired oxygen concentration of <40% and the offline process was feasible. Short-term belt machine generally reduces the high pressure level to ≤1.57 kPa, long-term high pressure machine level 0.98 ~ 1.17 kPa, high-low pressure level difference of 0.49 ~ 1.17 kPa, some patients with severe pulmonary function damage often require high pressure level close to the low pressure level = 0.49 kPa Complete the offline process. In both groups, the respiratory rate was set at 4 beats per minute and the respiratory rate was 1: 4. There was no significant change in the off-line parameters between the two groups (P> 0.05). Conclusions: BIPAP-SIMV-PSV is a better off-line method for patients who are difficult to take offline.