首都医科大学学报 ›› 2024, Vol. 45 ›› Issue (2): 226-232.doi: 10.3969/j.issn.1006-7795.2024.02.009

• 重症医学诊疗技术与进展 • 上一篇    下一篇

呼吸驱动和吸气努力的监测与评价

高  然1,  周建新2*   

  1. 1.首都医科大学附属北京天坛医院重症医学科,北京 100070; 2.首都医科大学附属北京世纪坛医院急救与重症医学中心 急性肺损伤临床与研究中心,北京 100038
  • 收稿日期:2023-12-19 出版日期:2024-04-21 发布日期:2024-04-25
  • 通讯作者: 周建新 E-mail:zhoujx.cn@icloud.com
  • 基金资助:
    首都卫生发展科研专项项目(首发2024-1-2081),首都医科大学临床与研究中心项目(CMU-2023-45)。

Dynamic monitoring of respiratory drive and inspiratory effort

Gao Ran1,  Zhou Jianxi2*   

  1. 1.Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 2.Emergency and Critical Care Medical Center, Clinical and Research Center on Acute Lung Injury, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2023-12-19 Online:2024-04-21 Published:2024-04-25
  • Supported by:
    This work was supported by Capital's Funds for Health Improvement and Research(2024-1-2081),  Clinical and Research Center Program of Capital Medical University (CMU-2023-45).

摘要: 肺-膈肌保护性通气旨在限制危重症患者在机械通气过程中肺和膈肌的副损伤。其中呼吸驱动和吸气努力的动态监测是临床实施肺-膈肌保护性通气的重点。本文按照呼吸驱动的生理路径,自上而下的在呼吸肌、压力变化和肺通气三个层面对现有的呼吸驱动和吸气努力的监测指标进行综述,分别对其意义、获得方式、相应界值以及优缺点逐一进行讨论。

关键词: 呼吸驱动, 吸气努力, 保护性通气

Abstract: Lung-diaphragmatic protective ventilation aims to limit damage to the lung and diaphragm during mechanical ventilation in critically ill patients. The dynamic monitoring of respiratory drive and inspiratory effort is the focus of the clinical strategies for implementating lung-diaphragm protective ventilation strategies. This paper reviews the existing indicators for dynamic monitoring of respiratory drive and inspiratory effort at the three levels of respiratory muscle, pressure change, and pulmonary ventilation according to the physiological pathway of respiratory drive and discusses their significance, acquisition methods, and thresholds.

Key words: respiratory drive, inspiratory effort, protective ventilation

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