- 期刊
Ventilator Autotriggering Caused by Cardiogenic Oscillation-A Case Report
心臟震顫造成之呼吸器自發性驅動－病例報告
摘要
呼吸器自發性驅動意指在病人無呼吸動作時，呼吸器仍給予病人通氣。換言之，在任何情況下只要符合驅動的條件，呼吸器即會給氣。近代呼吸器常使用的驅動條件通常是壓力驅動或者是氣流驅動。在某些情況下，呼吸器自發性驅動可能會發生，並造成病人的傷害。本病例報告中，病人因為嚴重心衰竭及反覆肺水腫而導致無法脫離呼吸器。因為呼吸急促，我們使用了高劑量的安眠劑及肌肉鬆弛劑，但發現病人依舊呈現呼吸急促。在測量了呼吸道壓力、食道壓力以及氣流後，病人呼吸急促的原因證實為心臟震顫造成之呼吸器自發性驅動。此現象只要我們調減驅動閾值的敏感度就可以消弭。
關鍵字
呼吸器自發性驅動並列摘要
Ventilator autotriggering refers to the initiation of mechanical breath in the absence of a patient's spontaneous inspiratory effort. In other words, ventilator autotriggering may occur under any condition, whenever the triggering criteria are met. Pressure-triggering and/or flow-triggering are the most frequent modes we have used as triggering variables. Under certain circumstances, ventilator autotriggering may occur and produce harmful effects. We report a patient with congestive heart failure with recurrent pulmonary edema who received prolonged ventilator support. During the treatment course, tachypnea was noted, despite a high level of sedatives and neuromuscular blocking agents. After measurement of airway pressure, airway flow, and esophageal pressure, tachypnea was proved to be caused by ventilator autotriggering as a result of cardiogenic oscillation. Ventilator autotriggering can be easily eliminated by decreasing the triggering sensitivity.
延伸閱讀
- 李威杰（2022）。心房顫動疾病及相關複雜性電燒治療介紹。奇美醫訊，(138)，11-13。https://www.airitilibrary.com/Article/Detail?DocID=P20180523001-202209-202208240007-202208240007-11-13
- Lee, C. C., Huang, S. Y., & Ko, W. C. (2018). 個案報告：以房室結電燒同時治療心室再同步治療去顫器病人之心房撲動併心室心率過速與不適當電擊引發之心室頻脈. 輔仁醫學期刊, 16(3), 133-139. https://doi.org/10.3966/181020932018091603004
- 蔡旼珊（2011）。心室顫動與電擊後心肌損傷之機轉〔博士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2011.02815
- Chen, L. C., & Chou, C. Y. (2010). 急性心衰竭患者合併心房纖維顫動之處理. 重症醫學雜誌, 11(3), 188-191. https://doi.org/10.30035/TCCM.201010.0003
- 許堯欽、謝元凱、王宏銘、廖啟卉、徐尉芳（2020）。心臟房室早期收縮合併陣發性心房顫動與多發性心室頻脈之中醫藥治療病例報告。中醫藥雜誌，31(1)，100-109。https://doi.org/10.6940/JCM.202006_31(1).08