机械通气是救治危重患者常用的呼吸支持手段,而撤机是逐渐地降低呼吸机对患者呼吸的支持,使患者完全过度到自主呼吸后撤除机械通气的过程
困难撤机是指患者需要3次SBT尝试,或从第1次SBT尝试后7 d才能撤离呼吸机。
呼吸机依赖(Dysfunctional Ventilatory Weaning Response, DVWR)是指患者机械通气时间大于24 h或断开呼吸机不能维持自主呼吸
有研究表明,ICU机械通气时间大于7 d的患者约占6%,而机械通气时间的延长和呼吸支持困难撤离是影响ICU患者住院时间和病死率的独立危险因素
本文通过报道1例59岁既往有重症肌无力8年病史,因肌无力危象机械通气继发膈肌萎缩致困难脱机呼吸机依赖患者,经过呼吸神经肌肉刺激仪锻炼膈肌功能成功脱机,旨在为医疗工作者提供治疗此类患者的经验。
关键词:呼吸神经肌肉电刺激; 膈肌萎缩; 呼吸机依赖; 脱机
呼吸神经肌肉刺激仪
(北京雅果科技有限公司)
文章来源:张鹏, et al."呼吸神经肌肉刺激仪在重症肌无力致呼吸机依赖患者脱机中的应用." 长治医学院学报 35.01(2021):71-75. doi:CNKI:SUN:CZYX.0.2021-01-021.
作者:张鹏,江海娇,周全,叶小铭,吴郊锋,孙瑞祥,袁莉萍,姜小敢,鲁卫华,陶秀彬. 皖南医学院弋矶山医院重症医学科;
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