目的 探討設(shè)計(jì)改裝EcoScreen冷凝器收集機(jī)械通氣患者呼出氣冷凝液( EBC) 的可行性。方法 ①體外模擬肺測(cè)試: 改裝EcoScreen冷凝器與模擬肺連接, 在干燥呼吸機(jī)管道不連接濕化器、連接不加溫濕化器、連接加溫濕化器三種不同連接狀態(tài)下機(jī)械通氣60 min, 觀察氣道壓和潮氣量( VT) 的變化, 并測(cè)量收集冷凝液量。②人體測(cè)試: 10 例患者在干燥呼吸機(jī)管道不連接濕化器狀態(tài)下進(jìn)行機(jī)械通氣20 min, 觀察氣道壓、VT、呼吸頻率及心率、血壓、SpO2 的變化。并測(cè)量收集冷凝液量。結(jié)果 ① 體外模擬肺測(cè)試發(fā)現(xiàn), 干燥呼吸機(jī)管道不連接濕化器機(jī)械通氣60 min 可收集冷凝液2. 2 mL, 期間氣道壓、VT無(wú)明顯增高, 冷凝器收集管腔無(wú)阻塞; 連接不加溫濕化器, 機(jī)械通氣中VT下降伴氣道壓升高, 50 min 時(shí)被迫中止測(cè)試, 發(fā)現(xiàn)冷凝器收集管腔被冷凝物質(zhì)明顯堵塞, 收集冷凝液5 mL; 連接加溫濕化器機(jī)械通氣60 min, 收集冷凝液10. 5 mL, 期間氣道壓輕度升高, VT輕度下降。②人體測(cè)試顯示, 干燥呼吸機(jī)管道不連接濕化器, 直接與呼吸機(jī)相連, 機(jī)械通氣20 min 可收集冷凝液2 mL, 收集過(guò)程中氣道壓、VT、呼吸頻率及心率、血壓和SpO2無(wú)顯著變化。結(jié)論 改裝EcoScreen 冷凝器可用于收集機(jī)械通氣患者的EBC。為獲得檢測(cè)所需的足量EBC 標(biāo)本, 并防止EBC 被稀釋和氣道阻塞, 建議脫離濕化器, 收集時(shí)間20 min, 同時(shí)加強(qiáng)呼吸機(jī)和臨床監(jiān)護(hù)。
引用本文： 張文彬 ,陳建榮,蔡映云. 改裝EcoScreen 冷凝器收集機(jī)械通氣患者呼出氣冷凝液的研究. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010, 9(4): 391-395. doi: 復(fù)制
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| 3. | 劉翱, 李少瑩, 楊偉康, 等. 支氣管哮喘患者呼出氣冷凝液中8 -異前列腺素水平的研究. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8 :337-340. |
| 4. | 陳燕文, 何權(quán)瀛, 尚穎, 等. 哮喘患者呼出氣冷凝液中硝酸鹽/亞硝酸鹽、白細(xì)胞介素4 和γ干擾素檢測(cè)的臨床意義. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8 : 131-134. |
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- 1. Horvath I, Hunt J, Barnes PJ, et al. Exhaled breath condensate:methodological recommendations and unresolved questions. Eur Respir J, 2005, 26 : 523-548.
- 2. 劉春濤. 呼出氣一氧化氮檢測(cè)技術(shù)的前景: 陽(yáng)光燦爛還是陰云密布? 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8: 318-321.
- 3. 劉翱, 李少瑩, 楊偉康, 等. 支氣管哮喘患者呼出氣冷凝液中8 -異前列腺素水平的研究. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8 :337-340.
- 4. 陳燕文, 何權(quán)瀛, 尚穎, 等. 哮喘患者呼出氣冷凝液中硝酸鹽/亞硝酸鹽、白細(xì)胞介素4 和γ干擾素檢測(cè)的臨床意義. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8 : 131-134.
- 5. 薛曉艷, 高占成. 機(jī)械通氣患者呼出氣冷凝液中硝酸鹽/ 亞硝酸鹽水平與肺部感染的相關(guān)性分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志,2009, 8: 333 -336.
- 6. Liu J, Conrad DH, Chow S, et al. Collection devices influence the constituents of exhaled breath condensate. Eur Respir J, 2007, 30 :807-808.
- 7. Prieto L, Ferrer A, Palop J, et al. Differences in exhaled breath condensate PH measements between samples obtained with two commercial devices. Respir Med, 2007, 101: 1715-1720.
- 8. Roca O, Gómez-Ollés S, Cruz MJ, et al. Effects of salbutamol on exhaled breath condensate biomarkers in acute lung injury:prospective analysis. Crit Care, 2008 , 12: R72.
- 9. Moloney ED, Mumby SE, Gajdocsi R, et al. Exhaled breath condensate detects markers of pulmonary inflammation after cardiothoracic surgery. Am J Respir Crit Care Med, 2004 , 169: 64 -69.
- 10. Muller WG, Morini F, Eaton S, et al. Safety and feasibility of exhaled breath condensate collection in ventilated infants and children. Eur Respir J, 2006, 28 : 479-485.