spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.17238/issn2223-2427.2019.1.33-37spractice-107Research ArticleСтатьиВЛИЯНИЕ РЕЖИМА КОМПЕНСАЦИИ СОПРОТИВЛЕНИЯ ДЫХАТЕЛЬНЫХ ПУТЕЙ НА ПОТРЕБЛЕНИЕ КИСЛОРОДА У ПАЦИЕНТОВ В ОТДЕЛЕНИИ ИНТЕНСИВНОЙ ТЕРАПИИTHE EFFECTS OF AIRWAY RESISTANCE COMPENSATION ON OxYGEN CONSUMPTION IN PATIENTS OF THE INTENSIVE CARE WARDПетроваМ. В.PetrovaM. V.

д.м.н. зав. кафедры анестезиологии и реаниматологии с курсом медицинской реабилитации

117198, г. Москва, ул. Миклухо-Маклая, д.6.

Doctor of Medical Sciences, Head Departments of Anaesthesiology and Resuscitation with a course of medical rehabilitation

117198, Moscow, st. Miklouho-Maclay, 6

mail@petrovamv.ruСергеевИ. В.SergeevI. V.

117198, г. Мос-ква, ул. МиклухоМаклая, д.6.

Resident, Department of Anaesthesiology and Resuscitation, Medical Institute

117198, Moscow, st. Miklouho-Maclay, 6

РубанесМ.RubanesM.

доцент

117198, г. Москва, ул. Миклухо-Маклая, д.6.

Assistant lecturer, Department of Anaesthesiology and Resuscitation, Medical Institute

117198, Moscow Miklukho-Maklaya str.6

ГароянВ. О.GaroyanV. O.

117198, г. Москва, ул. МиклухоМаклая, д.6.

Resident, Department of Anaesthesiology and Resuscitation, Medical Institute

117198, Moscow Miklukho-Maklaya str.6

ХабибуллоиН. Н.HabibullonN. N.

117198, г. Москва, ул. МиклухоМаклая, д.6.

Resident, Department of Anaesthesiology and Resuscitation, Medical Institute

117198, Moscow Miklukho-Maklaya str.6

СмолянинаВ. С.SmolyaninaV. S.

117198, г. Москва, ул. МиклухоМаклая, д.6.

Resident, Department of Anaesthesiology and Resuscitation, Medical Institute

117198, Moscow Miklukho-Maklaya str.6

ФГАОУ ВО «Российский университет дружбы народов»; ФГБНУ «Федеральный научный клинический центр анестезиологии и реаниматологии»РоссияRUDN University; FSBI «Federal Scientific Clinical Center of anaesthesiology and Resuscitation»Russian FederationФГАОУ ВО «Российский университет дружбы народов»РоссияRUDN UniversityRussian Federation201917042020013337Copyright © Петрова М.В., Сергеев И.В., Рубанес М., Гароян В.О., Хабибуллои Н.Н., Смолянина В.С., 20202020Петрова М.В., Сергеев И.В., Рубанес М., Гароян В.О., Хабибуллои Н.Н., Смолянина В.С.Petrova M.V., Sergeev I.V., Rubanes M., Garoyan V.O., Habibullon N.N., Smolyanina V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/107

У пациентов, нахождящихся на ИВЛ, самая большая проблема на работу дыхание это сопротивление от эндотрахеального трубки. Режим АТС обеспечит необходымие давление как компенсации сопротивление эндотрахеального трубки. Материалы и методы: В исследование вошли 20 пациентов находящиеся на ИВЛ в режиме вентиляции CPAP/PSV с трахеостомической трубкой диаметром 8,0 мм. Проводилась оценка параметры: чСС, АД, SpO2 , Ppeak, PS, PEEP, FiO2 , VO2 , VCO2 , EE, RQ, RSBI. Задавался степень компенсации 100% на режиме ARC. Длительность исследования составляла 60 минут на 1 пациента. Исследование прекращалось при декомпенсации состояния пациентов. Результаты: наблюдалось что средный чДД до включении АRС состоялось 20,3 ± 4,6 и средный чДД после включении АТС состоялось 20,8 ± 5,4, средный VO2 до включении АRС состоялось 238 ± 72,5 и средный VO2  после включении АТС состоялось 235,6 ± 70,7, и допольнительно наблюдали что быль рост на Ppeak ~ 3 мм вод ст максимум рост. Заключение: режим АТС не уменьшает работу дыхания так как все изучаемые параметры чСС, чДД, RSBI, VO2 , VCO2 не значительно поменялось.

In the mechanically ventilated patient, the single greatest cause of imposed work of breathing (WOB) is the resistance caused by the endotracheal tube (ETT). However, a special mode of ventilatory support called automatic tube compensation (ATC) delivers exactly the amount of pressure necessary to overcome the resistive load imposed by the ETT for the flow measured at the time (so-called variable pressure support). Materials and methods: 21 patients were included in our study who were on mechanical ventilation CPAP/PSV with tracheostomy tube of 8.0 mm. Pulse, BP, SpO2, Ppeak, PS, PEEP, FiO , VO2, VCO2 , EE, RQ, RSBI were monitored. 100% ARC compensation was given. Duration of observation was 60 minutes for each patient. Observation study was 2 stopped if patients’ condition deteriorated. Results: it was observed that mean BR before ARC was 20.3 ± 4.6 & mean BR after ARC was 20.8 ± 5.4, mean VO2 before ARC was 238 ± 72.5 & mean VO2 after ARC was 235.6 ± 70.7, in addition to that we observed that there was a rise in Ppeak of about 3 mm water column. Conclusion: ATC mode did not reduce the work of breathing as all the other measured parameters such as pulse, BR, RSBI, VO2, VCO2 didn’t have a significant change.

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The authors declare that there are no conflicts of interest present.