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Báo cáo y học: "Equipment review: Measurement of occlusion pressures in critically ill patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Equipment review: Measurement of occlusion pressures in critically ill patients. | Conti et al. Critical Care 1997 1 89 http ccforum.com c CRITICAL CARE REVIEW Equipment review Measurement of occlusion pressures in critically ill patients Giorgio Conti Massimo Antonelli Silvia Arzano Alessandro Gasparetto 93cc-1-3-089 Introduction The evaluation of airway pressure tracings during complete airway occlusion provides interesting functional data for weaning patients from mechanical ventilation. The occlusion manoeuvre may be achieved either by maintaining occlusion for a prolonged period during maximal inspiratory effort PiMax or for a shorter time period 200-300 ms . The inspiratory depression of airways pressure achieved after 100 ms of occlusion is generally defined as the occlusion pressure or P0.1 and represents a valid indirect measurement of the activity of the respiratory centres. P0.1 is a reliable measurement of the intensity of the stimuli from the neurological centres to the peripheral respiratory muscles 1 2 . Whitelaw et al elegantly demonstrated the reliability of this measurement 1 in human healthy volunteers spontaneously breathing at rest and during hypercapnic challenge. P0.1 can represent a more precise respiratory drive measurement than other measurements such as tidal volume respiratory rate minute ventilation or mean inspiratory flow VT Ti since it is relatively independent of modification by respiration machines. The aim of this article is to analyse the technical aspects relating to the acquisition of occlusion pressures taking into account the possible bias represented by specific physiopathologic situations and to define some future uses of P0.1 during weaning procedures. A complete review of the literature dedicated to P0.1 measurement in different clinical settings has been recently published 3 . P0.1 measurements P0.1 can be easily measured at the bedside in both poorly co-operative or mechanically ventilated patients. When first used in non-intubated patients this measurement required the separation of inspiration flow