期刊文献+

慢性阻塞性肺疾病急性加重患者的机械通气指南(2007) 预览 被引量:244

Guideline for mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (2007)
在线阅读 下载PDF
分享 导出
摘要 慢性阻塞性肺疾病(COPD)是一种常见的慢性呼吸系统疾病,患病人数多,病死率高,严重影响患者的劳动能力和生活质量。2002年世界卫生组织(WHO)公布的资料显示,COPD是目前世界上死亡的第五位病因,预计到2020年,COPD将成为第三位死亡病因。COPD急性加重(AECOPD)合并呼吸衰竭(呼衰)是导致COPD患者住院最重要的原因,加强对AECOPD的防治,特别是提高机械通气技术的应用水平,对提高AECOPD合并呼衰的抢救成功率具有重要意义。 Objective Chronic obstructive pulmonary disease (COPD) is one of the major causes of chronic morbidity and mortality throughout the world, while acute exacerbation of COPD (AECOPD) is one of the important causes for the patient to be hospitalized. As COPD is a disease state characterized by irreversible airflow limitation and dynamic pulmonary hyperinflation, the mechanical ventilation strategy for its AECOPD is different from other diseases. To improve the clinical result of mechanical ventilation for AECOPD, Chinese Society of Critical Care Medicine of Chinese Medical Association held a consensus conference to draft a guideline by categorizing all the information gathered from the literature into five grades from A to E, with A being the highest, according to a modified Delphi criteria. The main recommendations were as follows: 1. Noninvasive positive ventilation (NPPV) should be the routine option for AECOPD patients, particularly in hospitalized patients with mild to moderate exacerbations (7.25〈pH〈7.35) with obvious dyspnea (with use of accessory respiratory muscles). Appropriate choice of nose or nose and mouth mask, careful monitoring and staff training play important roles in the successful use of NPPV. 2. Invasive positive pressure ventilation is used in serious respiratory failure to ensure the effective ventilation and airway toilet. 3. Proper selection of ventilation mode, and careful adjustment of tidal volume, respiratory rate, inspiratory flow rate and positive end -expiratory pressure are important in oder to avoid dynamic pulmonary hyperinflation. 4. Sequential ventilation (early extubation following by NPPV) is recommended as a weaning strategy for intubated patients. 5. For those in whom exacerbation is due to pulmonary infection, NPPV should be initiated with pulmonary infection control (PIC) as the window to decrease the duration of invasive ventilation, the risk of ventilator associated pneumonia, and hospital mortality.
出处 《中国危重病急救医学》 CAS 北大核心 2007年第9期 513-518,共6页 Chinese Critical Care Medicine
关键词 慢性阻塞性肺疾病(COPD) 机械通气技术 急性 慢性呼吸系统疾病 世界卫生组织 AECOPD 指南 死亡病因 acute exacerbation of chronic obstructive pulmonary disease mechanical ventilation guideline
作者简介 工作小组成员:王辰,刘大为,席修明,邱海波,马晓春,黎毅敏,杜斌,詹庆元,解立新
  • 相关文献

同被引文献1740

引证文献244

二级引证文献1822

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈