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危重病

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膈肌减弱及其意义
原作者: Feras Khan,郑辛甜译,肖锋校对 发布日期:2015-03-03

 Title: Diaphragm weakness and its significance
作者:膈肌减弱及其意义
Author 作者: Feras Khan
翻译:郑辛甜 校对:肖锋


Diaphragm weakness and its significance
膈肌减弱及其意义
• Acute respiratory failure is partially due to respiratory muscles inability to meet the demands of respiration that is strained by a medical condition
• 急性呼吸衰竭的部分原因是呼吸肌不能满足由于疾病状态对呼吸要求的增加。
• Ventilation can have an adverse effect on respiratory muscles even after just 5-6 days (atrophy)
• 仅5~6天的通气就会对呼吸肌有不良的影响(萎缩)。
There are several ways to monitor diaphragm strength and function
有几种方式可监控膈肌的强度和功能:
• Airway pressure and flow waveforms
• 气道压力和流量波形
• Occlusion pressure
• (气道)阻断压
• Esophageal pressure waveforms
• 食管压力波形
• Sniff maneuvers
• 吸气手法
• Ultrasound
• 超声
• Diaphragm EMG
• 膈肌肌电图
• Chest xray
• 胸部X线
Clinical Relevance
临床意义
• Goal is to use these devices to limit the development of respiratory muscle atrophy because of disuse
• 目的是使用这些设备时要限制废用性呼吸肌萎缩
• Prevent "overassist" from the ventilator
• 防止过度呼吸机辅助呼吸
• Potential use in weaning trials to evaluate for respiratory muscle performance
• 在撤呼吸机试验中评估呼吸肌的性能
• This is a new area of intensive care research that could lead to improvements in outcomes
• 这是重症监护研究的一个新领域,可能会带来临床效果的改善

References 参考文献
Curr Opin Crit Care. 2015 Feb;21(1):34-41. doi: 10.1097/MCC.0000000000000168.
Monitoring and preventing diaphragm injury.
Heunks LM1, Doorduin J, van der Hoeven JG.