摘要
目的研究机械通气患者呼出气冷凝液（exhaled breath condensate，EBC）收集技术的临床安全性和可行性。方法28例机械通气患者采用改装EcoScreen冷凝器进行93次EBC收集。观察收集前、收集中和收集后三个阶段的呼吸监护和生命体征监护参数的变化。测量EBC收集量并检测其中一氧化氮（NO）和8-异前列烷（8-isoPG）的水平。结果①机械通气患者在EBC收集前与收集后的呼吸监护和生命体征监护参数的差异无统计学意义。②在EBC收集过程中，PSV模式下Vt、f和VM下降；A／C-PC模式下VT、f和VM下降，Pmean升高；A／C-VC模式下VT下降，PIP升高；其变化幅度均小于10％；HR、MAP和Sp02无明显变化。③收集期间VT无进行性下降。④VM为（10．68±4．24）L／min，30min内的EBC收集量为（4．70±1．48）ml。EBC收集量与VM相关（r=0．482，P〈O．01）。⑤机械通气患者EBC中NO和8-isoPG可以检出。结论使用改装Ecoscreen冷凝器对机械通气患者进行EBC采集具有临床安全性和可行性。为减少风险，建议预先评估病情，更换干燥管道，适当提高Vt设置，限制收集时间小于30min。
Objective The aim of this study was to develop a technique for the exhaled breath condensate （EBC） collecting from ventilated patients and assess its clinical safety and feasibility. Methods EBC was collected 93 times from 28 cases with mechanical ventilation by modified EcoScreen condensater. The changes of ventilatory and cilinical parameters were observed before, during, and after three stages of collections,the volume of EBC and the levels of NO and 8-isoPG in EBC were measured at last. Results① There was no statistical significance difference in breathing parameters （PIP, Pmean, Pplat,PEEP, f,VT and VM ）and the vital signs （HR, MAP and SpO2 ） of ventilated patients before and after EBC collection in ventilated patients.② During the collection of EBC, the ventilatory parameters slight changed within 10% （VT ,f and VM decreased in PSV. VT ,f and VM decreased and Pmean rised in A/C-PC. VT decreased and PIP rised in A/C-VC）,while the clinical parameters （HR,MAP and SpO2 ） did not significant changed. ③ VT did not decrease progressively during the collection. ④The VM was （10.68 ±4.24） L/min, the collection of EBC volume in 30 min was （4.70±1.48） ml. The EBC volume was related to the VM （ r =0, 482, P d0. 01）. 0 The NO and 8-isoPG in EBC was detectivable. Conclusions It is clinically safe and feasible to perform EBC collection in ventilated patients using modified EcoScreen condensers. To reduce the risk, it is recommended to assess patient＇s condition beforehand,to take dry ventilation pipe,to raise the VT set appropriately,and to limit the collecting time in 30 min.
出处
《国际呼吸杂志》
2012年第5期362-366,共5页
International Journal of Respiration
