雙相氣道正壓/氣道壓力釋放通氣的原理與應用

Translated title of the contribution: Biphasic Positive Airway Pressure/Airway Pressure Release Ventilation: Theory and Clinical Applications

龍 芳(Fang Long), 邊 苗瑛(Mauo-Ying Bien)

Research output: Contribution to journalArticle

Abstract

Recent advances in mechanical ventilation have been moved from controlled positive- pressure ventilation to adding spontaneous breathing in a controlled mode. It was suggested that ventilatory modes in which patients breathe spontaneously early in the course of the acute lung injury (ALI) process might have advantages such as improved pulmonary ventilation/perfusion matching, increased blood oxygenation, preserved cardiac function, reduced need for excessive sedatives and muscle relaxants, and prevention of ventilator-associated respiratory muscle dysfunction. Therefore, the biphasic positive airway pressure (BIPAP)/airway pressure release ventilation (APRV) modes are being increasingly used as alternative strategies to conventional assisted-control ventilation for critical patients with acute respiratory failure. Many commercially available ventilators possess these modes. Well-designed studies have demonstrated that these modes produce promising results in treating patients with ALI and acute respiratory distress syndrome.
The purpose of this review was to summarize the physiological effects of the BIPAP/APRV modes on the cardiovascular system, ventilation and oxygenation function, the use of sedatives and muscle relaxants, the work of breathing, and blood perfusion of the kidneys, liver, and gastrointestinal tract. The function of the BIPAP/APRV modes in various different ventilators is described, and the methods of clinical application are discussed.
Original languageTraditional Chinese
Pages (from-to)51-62
Number of pages12
Journal呼吸治療
Volume8
Issue number1
DOIs
Publication statusPublished - 2009

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Continuous Positive Airway Pressure
Mechanical Ventilators
Acute Lung Injury
Hypnotics and Sedatives
Pressure
Ventilation
Perfusion
Work of Breathing
Pulmonary Ventilation
Muscles
Respiratory Muscles
Positive-Pressure Respiration
Adult Respiratory Distress Syndrome
Cardiovascular System
Artificial Respiration
Respiratory Insufficiency
Gastrointestinal Tract
Respiration
Kidney
Liver

Keywords

  • Spontaneous breathing
  • Airway pressure release ventilation
  • Biphasic positive airway pressure ventilation

Cite this

雙相氣道正壓/氣道壓力釋放通氣的原理與應用. / 龍芳(Fang Long); 邊苗瑛(Mauo-Ying Bien).

In: 呼吸治療, Vol. 8, No. 1, 2009, p. 51-62.

Research output: Contribution to journalArticle

龍芳(Fang Long) ; 邊苗瑛(Mauo-Ying Bien). / 雙相氣道正壓/氣道壓力釋放通氣的原理與應用. In: 呼吸治療. 2009 ; Vol. 8, No. 1. pp. 51-62.
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abstract = "近年來呼吸器的設定與使用已逐漸由正壓通氣(positive-pressure ventilation)模式改變爲增加自主呼吸(spontaneous breath)爲主流的模式;研究指出,正壓通氣合併自主呼吸可降低氣道壓力、改善通氣灌流比、增加氧合、保護心臟功能及減少鎮定劑與肌肉鬆弛劑的使用;因此,雙相氣道正壓(biphasic positive airway pressure, BIPAP)/氣道壓力釋放通氣(airway pressure release ventilation, APRV)模式的使用逐漸受到重視,多種微電腦呼吸器皆具此模式。研究證實BIPAP/APRV可使急性呼吸窘迫症候群(acute respiratory distress syndrome, ARDS)病患的肺部獲得充分的復原以及預防併發症,成爲治療急重症呼吸衰竭病患時的重要通氣模式。本文主要探討病患使用BIPAP/APRV模式的生理效應、通氣與氧合功能及鎮定劑與肌肉鬆弛劑使用之相關研究,並討論各類型呼吸器所具備的功能與臨床使用方法,以提供臨床人員應用與照護病患之參考。",
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AU - 邊, 苗瑛(Mauo-Ying Bien)

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N2 - 近年來呼吸器的設定與使用已逐漸由正壓通氣(positive-pressure ventilation)模式改變爲增加自主呼吸(spontaneous breath)爲主流的模式;研究指出,正壓通氣合併自主呼吸可降低氣道壓力、改善通氣灌流比、增加氧合、保護心臟功能及減少鎮定劑與肌肉鬆弛劑的使用;因此,雙相氣道正壓(biphasic positive airway pressure, BIPAP)/氣道壓力釋放通氣(airway pressure release ventilation, APRV)模式的使用逐漸受到重視,多種微電腦呼吸器皆具此模式。研究證實BIPAP/APRV可使急性呼吸窘迫症候群(acute respiratory distress syndrome, ARDS)病患的肺部獲得充分的復原以及預防併發症,成爲治療急重症呼吸衰竭病患時的重要通氣模式。本文主要探討病患使用BIPAP/APRV模式的生理效應、通氣與氧合功能及鎮定劑與肌肉鬆弛劑使用之相關研究,並討論各類型呼吸器所具備的功能與臨床使用方法,以提供臨床人員應用與照護病患之參考。

AB - 近年來呼吸器的設定與使用已逐漸由正壓通氣(positive-pressure ventilation)模式改變爲增加自主呼吸(spontaneous breath)爲主流的模式;研究指出,正壓通氣合併自主呼吸可降低氣道壓力、改善通氣灌流比、增加氧合、保護心臟功能及減少鎮定劑與肌肉鬆弛劑的使用;因此,雙相氣道正壓(biphasic positive airway pressure, BIPAP)/氣道壓力釋放通氣(airway pressure release ventilation, APRV)模式的使用逐漸受到重視,多種微電腦呼吸器皆具此模式。研究證實BIPAP/APRV可使急性呼吸窘迫症候群(acute respiratory distress syndrome, ARDS)病患的肺部獲得充分的復原以及預防併發症,成爲治療急重症呼吸衰竭病患時的重要通氣模式。本文主要探討病患使用BIPAP/APRV模式的生理效應、通氣與氧合功能及鎮定劑與肌肉鬆弛劑使用之相關研究,並討論各類型呼吸器所具備的功能與臨床使用方法,以提供臨床人員應用與照護病患之參考。

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KW - Spontaneous breathing

KW - Airway pressure release ventilation

KW - Biphasic positive airway pressure ventilation

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