咪唑安定在机械通气人机对抗中疗效观察.docVIP

咪唑安定在机械通气人机对抗中疗效观察[摘要] 目的:探讨在机械通气时,咪唑安定在人机对抗中的运用。方法:对29例在进行机械通气治疗过程中,由于自身因素造成人机对抗,使用咪唑安定的患者进行回顾性研究。结果:29例患者中发生人机对抗原因中不耐受插管刺激14例,中枢性呼吸频率(节律)改变6例,多发伤疼痛8例,频繁呃逆导致误触发1例。结论:人机对抗是机械通气过程中常见问题,其发生的主要原因有患者自身因素,呼吸机性能,使用者技术水平3方面;来自于患者自身的因素主要有对插管不耐受,疼痛等因素。咪唑安定能有效地缓解患者焦虑情绪,减少来自患者自身因素引起的人机对抗,保持人机协调。 [关键词] 咪唑安定;机械通气;Ramsay镇静评分;人机对抗 [中图分类号] R971+3 [文献标识码]B [文章编号]1674-4721(2010)05(c)-045-02 The effect of Midazolam in human-machine confrontation of mechanical ventilation WAN Hongbo,SHANG Shiyu (ICU of the Third Hospital of Nanchang City,Jiangxi Province, Nanchang 330009, China) [Abstract] Objective: To investigate the mechanical ventilation, midazolam in the use of man-machine confrontation. Methods: 29 patients who occured man-machine confrontation that beacase of their own factors during the treatment of mechanical ventilation, patients who were used midazolam were studied retrospectively. Results: Occurred in 29 patients because of intolerance against the machine to stimulate the 14 cases of intubation, central respiratory frequency (rhythm) changes in 6 cases, 8 cases of multiple injury pain, frequent hiccups cause false triggering one case. Conclusion: Machine confrontation is a common problem of the process of mechanical ventilation. The main reasons for its occurrence are classified as patient’s own factors, breathing machine performance, skill of the operator; Factors derived from a patient’s own intolerance mainly on intubation intolerance, pain and other factors. Midazolam can effectively alleviate the anxiety of patients and reduce the factors from the patient’s own man-machine fight, to keep human-machine coordination. [Key words] Midazolam; Mechanical ventilation; Ramsay sedation score; Human-machine against 随着我国危重医学的发展,机械通气在重症监护室内得到广泛应用,其并发症也日益引起我们重视,而人机对抗是机械通气治疗过程中最常见的并发症之一,其实质就是呼吸机和自主呼吸两个呼吸泵节奏不协调引起的异常人机关系。人机对抗会使患者分钟通气量和潮气量下降,呼吸功增加,加重二氧化碳潴留及低氧血症,循环负荷加重,严重时可危及患者生命[1]。本文对本院ICU 2008年1月~2009年12月29例在机械通气时出现人机对抗并使用咪唑安定镇静的患者进行分析,探讨咪唑安定在人机对抗中的运用。 1 资料