Autori v práci opisujú možné riziko inpulzného efektu, ktorý vzniká aj pri konvenčnej ventilácii, ak je pomer TI : TE < 0,5 (Ti % < 33 %). Analyzujú zmeny exspiračnej časovej konštanty, podporného tlaku, pomeru TI:TE, frekvencie ventilácie, FiO2, SpO2, statickej poddajnosti a odporu dýchacích ciest, ktoré boli monitorované vo ventilačnom režime tlakovej podpory (pressure support, PS). Autori zistili, že pri dlhodobom poklese Ti % < 33 % (28 ± 3) dochádza po niekoľkých desiatkách hodín k postupnému znižovaniu statickej poddajnosti a vzostupu odporu dýchacích ciest. Na udržanie výmeny plynov (MV) v režime PS museli zvyšovať podporný tlak Pps. Z vyššie uvedených skutočností dedukovali prítomnosť trvalého inpulzného efektu umelej ventilácie pľúc, čo zhoršuje drenážnu funkciu hlavne v malých dýchacích cestách. Na elimináciu inpulzného efektu použili intermitentnú expulziu pomocou vysokofrekvenčnej dýzovej ventilácie (VFDV). Dokumentujú zlepšenie pľúcnej mechaniky po aplikácii expulzie pomocou VFDV. Záverom upozorňujú na možné riziko zhoršovania pľúcnej mechaniky pri ventilácii v režime PS (ASB) v prípade, že dôjde k situácii, kedy je dlhodobo Ti % < 33 %.
The authors describe the possible risk of inpulsion effect arising during conventional ventilation if TI:TE ratio is less than 0.5 (Ti% < 33%). They analyze changes of expiratory time constant, pressure support, TI:TE ratio, ventilation frequency, FiO2, SpO2, static compliance and respiratory resistance which were monitored during ventilation in pressure support mode (pressure support PS). The authors have found that during prolonged decrease of Ti < 33% (28 ± 3) there could be observed a decrease of static compliance and increase of respiratory tract resistance, evolving gradually during several tens of hours. To maintain the gas exchange (MV) in PS mode there is a need to increase pressure support Pps. Based upon above mentioned findings, there was postulated a theory of persistent inpulsion effect of mechanical ventilation of the lungs that worsens the drainage function of the lungs especially in distal respiratory airways. To eliminate this inpulsion effect, high-frequency jet ventilation (HFJV) was used intermittently for its expulsion effect. After application of expulsion effect using HFJV, improvement of lung mechanics could be documented. At the end the authors stress the possible risk of worsening lung mechanics during ventilation in PS mode (ASB) under the condition that Ti% < 33% is applied for prolonged time.
- MeSH
- Blood Gas Analysis MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Airway Obstruction etiology prevention & control MeSH
- Ventilator Weaning adverse effects statistics & numerical data MeSH
- Airway Resistance MeSH
- Risk MeSH
- Aged MeSH
- Pressure MeSH
- Respiration, Artificial methods standards statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
WHO global programme on AIDS ; 029
13 s. ; 30 cm
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- dermatovenerologie
- NML Publication type
- publikace WHO
- MeSH
- Child MeSH
- Cardiopulmonary Resuscitation * methods standards MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Home Childbirth MeSH
- Nurse Midwives MeSH
- Natural Childbirth nursing MeSH
- Heart Arrest therapy MeSH
- Emergency Medical Services methods standards legislation & jurisprudence MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Humans MeSH
- Group Processes MeSH
- Social Support MeSH
- Self-Help Groups MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Gut ; Supplement Vol. 35. 1
[1st ed.] VI, S80 s. : bar.fot., obr., tab., grafy ; 28 cm
- MeSH
- Diet Therapy MeSH
- Enteral Nutrition MeSH
- Immunity MeSH
- Intestinal Diseases MeSH
- Food MeSH
- Intestinal Mucosa microbiology physiology MeSH
- Publication type
- Collected Work MeSH
- Conspectus
- Lékařské vědy. Lékařství
- NML Fields
- gastroenterologie
- nutriční terapie, dietoterapie a výživa
- fyziologie
... State social support 44 -- 3.1. General overview 44 -- 3.2. Awarding procedures 44 -- 3.3. ... ... State social support benefits 49 -- 4.1. Child allowance 49 -- 4.2. Social allowance 50 -- 4.3. ... ... State social support and the European Union 59 -- 6. References 61 -- 7. Annex 62 -- 7.1. ... ... Formulas for state social support benefits calculations 62 -- 7.2. Statistical data 68 ...
1 vyd. 69 s. : il. ; 20 cm
