- 期刊
Reverse-Triggered Breaths in Mechanical Ventilation- A Case Report
呼吸器通氣中的反向驅動呼吸－病例報告
摘要
病患－呼吸器不協調（patient-ventilator asynchrony）與呼吸器的延長使用及其併發症有關。「反向驅動（reverse triggering）」是其中一種最近才被確認的「病患－呼吸器不協調」模式，在此模式中患者的呼吸運動會被呼吸器強制誘發。它展現出一種反覆且固定的神經－機械偶合（neuro-mechanical coupling）模式。在「反向驅動」產生時，患者吸氣肌的延遲活化可能導致雙重驅動（double triggering）、吐氣期障礙、以及增加肺泡壓並伴隨肺損傷。在處理此種病患－呼吸器不協調上，建議減少鎮靜的深度。我們藉由食道球壓力監測，展示該模式下的一例個案。
並列摘要
Patient-ventilator asynchrony (PVA) is associated with prolonged mechanical ventilator use and related complications. ＂Reverse triggering＂ is a recently recognized pattern of PVA, in which the patient's breathing is triggered by a mandatory breath from the ventilator. This denotes a neuro-mechanical coupling in a repetitive and consistent manner. In reverse triggering, the deferred activation of the patient's inspiratory muscles may induce double triggering, impairment of expiration, and increasing alveolar pressure with lung injury. Reduction of the sedation level is recommended for this type of PVA. We report a case with this specific PVA with esophageal pressure recording.