Tuberculosis and Respiratory Diseases
- Volume 41 Issue 4
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- Pages.372-378
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- 1994
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- 1738-3536(pISSN)
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- 2005-6184(eISSN)
A Comparison of Clinical Efficacy of Weaning Method Between the Mode of Intermittent Mandatory Ventilation and Intermittent Mandatory Ventilation Plus Pressure Support
기계적 호흡 치료로부터의 이탈방법으로서 Intermittent Mandatory Ventilation 단독 사용과 Pressure Support를 병용한 Intermittent Mandatory Ventilation의 비교
- Choi, Jeong-Eun (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
-
Koh, Youn-Suck
(Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
- Cho, Won-Kyoung (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
-
Lim, Chae-Man
(Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
- Kim, Woo-Sung (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan) ;
- Park, Pyung-Hwan (Department of Anesthesia, Asan Medical Center, College of Medicine, University of Ulsan) ;
- Choi, Jong-Moo (Department of Anesthesia, Asan Medical Center, College of Medicine, University of Ulsan) ;
- Kim, Won-Dong (Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan)
- 최정은 (울산의대 서울중앙병원 내과학교실) ;
-
고윤석
(울산의대 서울중앙병원 내과학교실) ;
- 조원경 (울산의대 서울중앙병원 내과학교실) ;
-
임채만
(울산의대 서울중앙병원 내과학교실) ;
- 김우성 (울산의대 서울중앙병원 내과학교실) ;
- 박평환 (울산의대 서울중앙병원 마취과학교실) ;
- 최종무 (울산의대 서울중앙병원 마취과학교실) ;
- 김원동 (울산의대 서울중앙병원 내과학교실)
- Published : 1994.08.31
Abstract
Background: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiraory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by an endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object: The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation(IMV) in facilitating weaning precess compaired to IMV mode alone. Method: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant throught the weaning period. For the patients who required mechanical ventilation for less than 72 hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning trial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. Results: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. Conclusion: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm
연구배경 : PSV는 시술자가 정해준 만큼의 양압으로 기관 삽관 환자의 자발적 흡기 노력을 도울 수 있는 새로운 기계 호흡 방식으로서 5~10cm