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DOI: 10.3791/65431-v
Catherine A. Bellissimo1, Idunn S. Morris2,3,4, Jenna Wong1, Ewan C. Goligher1,2,3,5
1Toronto General Hospital Research Institute, 2Interdepartmental Division of Critical Care Medicine,University of Toronto, 3Department of Physiology, Faculty of Medicine,University of Toronto, 4Deparatment of Intensive Care Medicine,Nepean Hospital, 5Division of Respirology, Department of Medicine,University Health Network
Please note that some of the translations on this page are AI generated. Click here for the English version.
可以使用床旁超声评估健康个体和危重患者的隔膜厚度和功能。该技术为评估隔膜结构和功能提供了一种准确、可重复、可行且耐受性良好的方法。
我们研究了机械通气对膈肌结构和功能的影响,以及这些变化对急性呼吸衰竭患者结局的影响。膈肌萎缩和功能障碍常见于机械通气患者,与膈肌不活动或通气时负荷过大有关。这种呼吸机引起的膈肌功能障碍会延迟恢复,并阻止患者在没有呼吸机帮助的情况下呼吸。
在机械通气过程中监测隔膜活动具有挑战性,通常需要侵入性方法。然而,床旁超声提供了一种非侵入性和可重复的方法来可视化和测量隔膜厚度和功能,包括萎缩等结构变化。该协议为在健康和危重症人群中获得隔膜结构和功能的测量提供了最佳实践指南。
在机械通气的重症监护患者中,膈肌厚度相对于基线的变化与膈肌无力和机械通气失败有关。通过呼吸努力、靶向镇静和膈神经刺激等治疗策略来靶向最佳呼吸努力可能能够减轻呼吸机引起的膈肌功能障碍,并促进肺和膈肌保护性通气。这些治疗策略对隔膜结构和功能的影响还有待评估。
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