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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Keywords

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

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