“Usambokahadzika kuti boka duku revagari vemo vane pfungwa, vakazvipira vanogona kuchinja nyika.Kutaura zvazviri, ndiyo chete iripo.”
Chinangwa cheCureus ndechekushandura iyo yakagara iripo modhi yekudhindisa yezvokurapa, umo kuendesa tsvakiridzo kunogona kudhura, kwakaoma, uye kutora nguva.
Taura chinyorwa ichi se: Kojima Y., Sendo R., Okayama N. et al.(Chivabvu 18, 2022) Yakafemerwa mwero weokisijeni mumidziyo yakaderera uye yakanyanya kuyerera: chidzidzo chekuenzanisa.Kurapa 14(5): e25122.doi:10.7759/cureus.25122
Chinangwa: Chikamu cheokisijeni yakafemerwa inofanira kuyerwa kana okisijeni inopiwa kumurwere, sezvo inomiririra alveolar oxygen concentration, iyo yakakosha kubva pakuona kwekufema physiology.Nokudaro, chinangwa chechidzidzo ichi chaiva chekuenzanisa chikamu cheokisijeni yakafemerwa yakawanikwa nemidziyo yakasiyana-siyana yekuendesa okisijeni.
Nzira: Muenzaniso wekufananidza wekufema wega wakashandiswa.Pima chikamu cheokisijeni yakafemerwa inotambirwa kuburikidza yakaderera uye yakakwirira kuyerera nasal prongs uye nyore okisijeni masks.Mushure memasendimita 120 eokisijeni, chikamu chemweya wakafemerwa chakayerwa sekondi yega yega kwemasendi makumi matatu.Zviyero zvitatu zvakatorwa kune chimwe nechimwe.
RESULTS: Airflow yakaderera intracheal yakafuridzirwa okisijeni chikamu uye extraoral oxygen concentration kana uchishandisa yakaderera-kuyerera nasal cannula, zvichiratidza kuti kufema kwekufema kwakaitika panguva yekufema uye kunogona kusanganiswa nekuwedzera kwemukati metracheal yakafuridzirwa oksijeni chikamu.
Mhedziso.Oxygen inhalation panguva yekufema kunogona kutungamirira kukuwedzera kwekuwedzera kweokisijeni munzvimbo yakafa yeanatomical, iyo inogona kusanganiswa nekuwedzera kwechikamu cheokisijeni inofemerwa.Kushandisa kuyerera kwepamusoro nasal cannula, chikamu chikuru cheokisijeni inoputika inogona kuwanikwa kunyange pakuyerera kwe10 L / min.Paunenge uchitarisa huwandu hwakakwana hweokisijeni, zvakakosha kuisa chiyero chakakodzera chekuyerera kune murwere uye mamiriro ezvinhu chaiwo, pasinei nekukosha kwechikamu chemukati weokisijeni inoputika.Paunenge uchishandisa yakaderera-kuyerera nasal prongs uye nyore okisijeni masikisi munzvimbo yekiriniki, zvinogona kuve zvakaoma kufungidzira chikamu cheokisijeni yakafemerwa.
Kutungamirirwa kweokisijeni panguva yakaoma uye isingaperi zvikamu zvekutadza kufema inzira yakajairika mumishonga yekiriniki.Nzira dzakasiyana-siyana dzekutonga kweokisijeni dzinosanganisira cannula, nasal cannula, oxygen mask, reservoir mask, venturi mask, uye high flow nasal cannula (HFNC) [1-5].Chiyero cheokisijeni mumhepo yakafemerwa (FiO2) chikamu cheokisijeni mumhepo inofemerwa inobatanidzwa mukutsinhana kwegasi realveolar.Chiyero cheokisijeni (P/F ratio) ireshiyo yechikamu chekumanikidzwa kweokisijeni (PaO2) kusvika kuFiO2 muropa re arterial.Kunyange zvazvo kuongororwa kwehuwandu hwehuwandu hweP / F hunoramba huchikakavadzana, iyo inonyanya kushandiswa chiratidzo cheokisijeni mumakiriniki maitiro [6-8].Nokudaro, zvakakosha kuchipatara kuziva kukosha kweFiO2 paunenge uchipa okisijeni kumurwere.
Munguva yekudzivirira, FiO2 inogona kuyerwa zvakarurama neokisijeni monitor iyo inosanganisira mhepo yemhepo, nepo okisijeni inoshandiswa nemhino cannula uye mask yeokisijeni, chete "kufungidzira" kweFiO2 kunobva panguva yekufema kunogona kuyerwa.Ichi "chibodzwa" chiyero cheokisijeni inopihwa kusvika kuhuwandu hwemvura.Nekudaro, izvi hazvifungi nezve zvimwe zvinhu kubva pakuona kweiyo physiology yekufema.Zvidzidzo zvakaratidza kuti zviyero zveFiO2 zvinogona kukanganiswa nezvinhu zvakasiyana [2,3].Kunyange zvazvo kutungamirirwa kweokisijeni panguva yekufema kunogona kutungamirira kuwedzera kwekuwedzera kweokisijeni munzvimbo dzakafa dzeanatomical dzakadai semuromo wemuromo, pharynx uye trachea, hapana mishumo panyaya iyi mumabhuku emazuva ano.Nekudaro, vamwe varapi vanotenda kuti mukuita zvinhu izvi hazvina kukosha uye kuti "zvibodzwa" zvakakwana kukurira matambudziko ekiriniki.
Mumakore achangopfuura, HFNC yakakwezva kunyanya kutarisisa mukurapa kwekukurumidzira uye nekuchengetedza kwakanyanya [9].HFNC inopa yakakwira FiO2 uye kuyerera kweokisijeni nemabhenefiti maviri makuru - kuputika kwenzvimbo yakafa ye pharynx uye kuderedzwa kwenasopharyngeal resistance, iyo isingafaniri kuregererwa painoraira okisijeni [10,11].Mukuwedzera, zvingave zvakakosha kufungidzira kuti iyo yakayerwa yeFiO2 kukosha inomiririra kukanganiswa kweokisijeni mumhepo kana alveoli, sezvo kuwedzera kweokisijeni mualveoli panguva yekufemerwa kwakakosha maererano nehuwandu hweP / F.
Nzira dzekuunza okisijeni kunze kwekunge intubation dzinowanzoshandiswa mumuitiro wekiriniki.Naizvozvo, zvakakosha kuunganidza data rakawanda paFiO2 yakayerwa neiyi okisijeni dhizaini kuitira kudzivirira zvisina kufanira overoxygenation uye kuwana ruzivo rwekuchengetedza kufema panguva yeokisijeni.Zvisinei, kuyerwa kweFiO2 mutrachea yevanhu kwakaoma.Vamwe vatsvakurudzi vakaedza kutevedzera FiO2 vachishandisa mamodheru ekufema [4,12,13].Naizvozvo, muchidzidzo ichi, takavavarira kuyera FiO2 tichishandisa muenzaniso wakamisikidzwa wekufema wega.
Ichi chidzidzo chekutyaira chisingade kubvumidzwa kwehunhu nekuti hachisanganisire vanhu.Kuti titevedzere kufema kwega, takagadzira modhi yekufema yega tichitarisa kumuenzaniso wakagadzirwa naHsu et al.(Mufananidzo 1) [12].Ventilators uye test mapapu (Dual Adult TTL; Grand Rapids, MI: Michigan Instruments, Inc.) kubva kune anesthesia midziyo (Fabius Plus; Lübeck, Germany: Draeger, Inc.) yakagadzirirwa kutevedzera kufema kwega.Midziyo miviri iyi yakabatana nemaoko nemabhandi esimbi akaomarara.Imwe bhero (divi rekutyaira) yebvunzo bapu yakabatana neinofema.Imwe mabhero (passive side) yemapapu ebvunzo yakabatana ne "Oxygen Management Model".Kana mhepo inofefetera ichipa gasi nyowani yekuyedza mapapu (divi rekutyaira), mavhuvhu anokwiridzirwa nekudhonza nechisimba kune mamwe mabhero (passive side).Kufamba uku kunofemera gasi kuburikidza nemanikin's trachea, nokudaro kutevedzera kufema kwega.
(a) oxygen monitor, (b) dummy, (c) test lung, (d) anesthesia device, (e) oxygen monitor, uye (f) electric ventilator.
Zvirongwa zveventilator zvaive sezvizvi: tidal volume 500 ml, kufema kufema 10 kufema / min, inspiratory kusvika expiratory ratio (inhalation / expiration ratio) 1: 2 (nguva yekufema = 1 s).Kune zviedzo, kutevedzera mapapu ebvunzo kwakaiswa ku 0.5.
Oxygen monitor (MiniOx 3000; Pittsburgh, PA: American Medical Services Corporation) uye manikin (MW13; Kyoto, Japan: Kyoto Kagaku Co., Ltd.) yakashandiswa pamuenzaniso wekutonga oksijeni.Okisijeni yakachena yakaiswa pamitengo ye1, 2, 3, 4 uye 5 L / min uye FiO2 yakayerwa kune imwe neimwe.KuHFNC (MaxVenturi; Coleraine, Northern Ireland: Armstrong Medical), okisijeni-mhepo misanganiswa yaipihwa muhuwandu hwe10, 15, 20, 25, 30, 35, 40, 45, 50, 55, uye 60 L, uye FiO2 yaive. inoongororwa pane imwe neimwe nyaya.KuHFNC, zviedzo zvakaitwa pa45%, 60% uye 90% oxygen concentrations.
Extraoral oxygen concentration (BSM-6301; Tokyo, Japan: Nihon Kohden Co.) yakayerwa 3 cm pamusoro pemaxillary incisors neokisijeni yakaunzwa kuburikidza nemhino cannula (Finefit; Osaka, Japan: Japan Medicalnext Co.) (Mufananidzo 1).) Intubation uchishandisa electric ventilator (HEF-33YR; Tokyo, Japan: Hitachi) kufuridzira mweya kubva mumusoro wemanikin kubvisa expiratory back-breathing, uye FiO2 yakayerwa 2 maminetsi gare gare.
Mushure memasekonzi e120 ekusangana neokisijeni, FiO2 yakayerwa sekondi yega yega kwemasekonzi makumi matatu.Ventilate iyo manikin nerabhoritari mushure meyero yega yega.FiO2 yakayerwa 3 nguva mune imwe neimwe mamiriro.Kuedza kwakatanga mushure mekuenzanisa kwechimwe nechimwe chekuyeresa chiridzwa.
Sechinyakare, okisijeni inoongororwa kuburikidza nenasal cannulas kuitira kuti FiO2 igone kuyerwa.Nzira yekuverenga yakashandiswa muchiedzo ichi yakasiyana zvichienderana nezviri mukati mekufema kwega (Table 1).Zvikoro zvinotarwa zvichienderana nemamiriro ekufema akaiswa muanesthesia device (tidal volume: 500 ml, kufema kufema: 10 breaths / min, inspiratory to expiratory ratio {inhalation: exhalation ratio} = 1: 2).
"Zvikoro" zvinoverengerwa kune yega yega oxygen kuyerera.A nasal cannula yakashandiswa kupa okisijeni kuLFNC.
Ongororo dzese dzakaitwa pachishandiswa Origin software (Northampton, MA: OriginLab Corporation).Mhedzisiro inoratidzwa seyanoreva ± yakajairwa kutsauka (SD) yenhamba yebvunzo (N) [12].Takatenderedza mibairo yese kunzvimbo mbiri dzedesimali.
Kuti uverenge "score", huwandu hweokisijeni inofemerwa mumapapu mumhepo imwe chete yakaenzana nehuwandu hweokisijeni mukati memhino cannula, uye imwe yese iri kunze kwemhepo.Saka, nenguva yekufema ye2 s, iyo okisijeni inounzwa nenasal cannula mu2 s ndeye 1000/30 ml.Muyero weokisijeni wakawanikwa kubva kunze kwemhepo waiva 21% yehuwandu hwemvura (1000/30 ml).Iyo yekupedzisira FiO2 huwandu hweokisijeni inounzwa kune vhoriyamu yemvura.Nokudaro, "kufungidzira" kweFiO2 kunogona kuverengwa nekuparadzanisa huwandu hweokisijeni inopedzwa nehuwandu hwemhepo.
Pamberi peyero yega yega, iyo intracheal okisijeni yekutarisa yakaverengerwa pa20.8% uye extraoral okisijeni yekutarisa yakagadziriswa pa21%.Tafura 1 inoratidza iyo inorehwa FiO2 LFNC kukosha pane yega yega yekuyerera.Aya maitiro ari 1.5-1.9 nguva dzakakwirira pane "akaverengerwa" kukosha (Table 1).Kusangana kweokisijeni kunze kwemuromo kwakakwira kupfuura mumhepo yemukati (21%).Avhareji kukosha kwakaderera kusati kwatanga kuyerera kwemhepo kubva kune feni yemagetsi.Aya maitiro akafanana ne "estimate values".Nekuyerera kwemhepo, apo okisijeni inopinda kunze kwemuromo iri pedyo nemhepo yekamuri, kukosha kweFiO2 mu trachea yakakwirira kudarika "kuverengwa kunokosha" kupfuura 2 L / min.Iine kana isina kubuda kwemhepo, mutsauko weFiO2 wakaderera sezvo kuyerera kwakawedzera (Mufananidzo 2).
Tafura 2 inoratidza avhareji yeFiO2 kukosha pane yega yega okisijeni mask yeokisijeni mask (Ecolite oxygen mask; Osaka, Japan: Japan Medicalnext Co., Ltd.).Aya maitiro akawedzera nekuwedzera oxygen concentration (Table 2).Nekushandiswa kwakafanana kweokisijeni, iyo FiO2 yeLFNK yakakwirira kudarika iyo iri nyore oksijeni mask.Pa1-5 L / min, musiyano muFiO2 inenge 11-24%.
Tafura 3 inoratidza avhareji yeFiO2 kukosha kweHFNC pane yega yega chiyero chekuyerera uye oxygen concentration.Aya makoshero aive padhuze nekunangwa kweokisijeni yekumisikidza zvisinei nekuti kuyerera kwaive kwakaderera kana kwakakwira (Tafura 3).
Intracheal FiO2 tsika dzaive dzakakwirira pane 'inofungidzirwa' kukosha uye extraoral FiO2 hunhu hwaive hwakakwira kupfuura mhepo yemukamuri kana uchishandisa iyo LFNC.Kuyerera kwemhepo kwakawanikwa kudzikisa intracheal uye extraoral FiO2.Mhedzisiro iyi inoratidza kuti kufema kwekufema kwakaitika panguva yeLFNC kufema zvakare.Iine kana isina kuyerera kwemhepo, iyo FiO2 mutsauko inoderera sezvo kuyerera kunowedzera.Ichi chigumisiro chinoratidza kuti chimwe chinhu chinogona kusanganiswa neFiO2 yakakwirira mu trachea.Mukuwedzera, vakaratidzawo kuti oxygenation inowedzera kuwedzera kweokisijeni munzvimbo yakafa yeatomical, iyo inogona kunge yakakonzerwa nekuwedzera kweFiO2 [2].Zvinowanzogamuchirwa kuti LFNC haikonzeri kufema pakufema.Zvinotarisirwa kuti izvi zvinogona kukanganisa zvakanyanya mutsauko uripo pakati peyakayerwa uye "inofungidzirwa" kukosha kwemhino cannulas.
Pakuyerera kwakaderera kwe1-5 L / min, iyo FiO2 yemasikisi akajeka yaive yakaderera kupfuura iyo yemhino cannula, pamwe nekuti iyo oksijeni yekuisa haina kuwedzera nyore kana chikamu chemasikisi chikava nzvimbo yakafa yeanatomically.Kuyerera kweokisijeni kunoderedza kuderedzwa kwemhepo yemukamuri uye inodzikamisa FiO2 pamusoro pe5 L/min [12].Pazasi pe5 L/min, yakaderera FiO2 tsika dzinoitika nekuda kwekuderedzwa kwemhepo yekamuri uye kufemazve kwenzvimbo yakafa [12].Muchokwadi, iko kurongeka kwemamita ekuyerera kweokisijeni kunogona kusiyana zvakanyanya.Iyo MiniOx 3000 inoshandiswa kutarisisa huwandu hweokisijeni, zvisinei kuti mudziyo hauna kukwana kwechinguva kugadzirisa kuyera shanduko mune exhaled oxygen concentration (vagadziri vanotsanangura masekonzi makumi maviri kumiririra 90% mhinduro).Izvi zvinoda mucherechedzo weokisijeni nemhinduro yenguva inokurumidza.
Mukuita kwekiriniki chaiyo, morphology yemhino yemhino, yemuromo, uye pharynx inosiyana kubva kumunhu nemunhu, uye kukosha kweFiO2 kunogona kusiyana nemhedzisiro inowanikwa muchidzidzo ichi.Mukuwedzera, mamiriro ekufema kwevarwere anosiyana, uye kushandiswa kweokisijeni yakakwirira kunotungamirira kuhuwandu hweokisijeni mukufema kwekufema.Aya mamiriro anogona kutungamira kune yakaderera FiO2 kukosha.Nokudaro, zvakaoma kuongorora FiO2 yakavimbika paunoshandisa LFNK uye masikisi emhepo yakapfava mumamiriro ezvinhu chaiwo ekiriniki.Nekudaro, kuyedza uku kunoratidza kuti pfungwa dzeanatomical yakafa nzvimbo uye kudzokorora kufema kwekufema kunogona kukanganisa FiO2.Tichifunga nezve kuwanikwa uku, FiO2 inogona kuwedzera zvakanyanya kunyange pamitengo yakaderera yekuyerera, zvichienderana nemamiriro ezvinhu pane "kufungidzira".
IBritish Thoracic Society inokurudzira kuti varapi vanyore okisijeni maererano nechinangwa chekuzadza uye kutarisa murwere kuti achengetedze chinangwa chekuzadza [14].Kunyange zvazvo "calculated value" yeFiO2 muchidzidzo ichi yakanga yakaderera zvikuru, zvinokwanisika kuwana FiO2 chaiyo yakakwirira kudarika "kukosha kwakaverengwa" zvichienderana nemamiriro emurwere.
Paunenge uchishandisa HFNC, iyo FiO2 kukosha iri padyo neyakaiswa okisijeni concentration zvisinei nekuyerera kweyero.Zvigumisiro zvechidzidzo ichi zvinoratidza kuti mazinga eFiO2 akakwirira anogona kuwanikwa kunyange pakuyerera kwe10 L / min.Zvidzidzo zvakafanana zvakaratidza hapana shanduko muFiO2 pakati pe10 ne30 L [12,15].Iyo yakanyanya kuyerera mwero weHFNC inonzi inobvisa kukosha kwekufunga anatomical yakafa nzvimbo [2,16].Anatomical yakafa nzvimbo inogona kugezwa kunze pamwero weokisijeni inoyerera inopfuura 10 L/min.Dysart et al.Zvinofungidzirwa kuti iyo yekutanga nzira yekuita kweVPT inogona kunge iri kuputika kwenzvimbo yakafa ye nasopharyngeal cavity, nokudaro kuderedza nzvimbo yose yakafa uye kuwedzera chikamu cheminiti yemhepo (kureva, alveolar ventilation) [17].
Chidzidzo chekare cheHFNC chakashandisa catheter kuyera FiO2 mu nasopharynx, asi FiO2 yakanga yakaderera pane iyi kuedza [15,18-20].Ritchie et al.Izvo zvakataurwa kuti iyo yakaverengerwa kukosha kweFiO2 inosvika ku0.60 sezvo gasi rinoyerera richiwedzera pamusoro pe30 L / min panguva yekufema kwemhino [15].Mukuita, HFNCs inoda kuyerera kwe10-30 L/min kana kupfuura.Nekuda kwezvivakwa zveHFNC, mamiriro ari mumhino yemhino ane mhedzisiro yakakosha, uye HFNC inowanzo shandiswa pahuwandu hwekuyerera.Kana kufema kuchivandudza, kuderera kwehuwandu hwekuyerera kunogonawo kudiwa, sezvo FiO2 inogona kukwana.
Iyi mhedzisiro yakavakirwa pakuenzanisa uye hairatidze kuti FiO2 mhedzisiro inogona kushandiswa zvakananga kune varwere chaivo.Nekudaro, zvichibva pane izvi zvabuda, kana iri intubation kana zvishandiso zvisiri zveHFNC, FiO2 kukosha kunogona kutarisirwa kusiyanisa zvakanyanya zvichienderana nemamiriro.Paunenge uchipa okisijeni neLFNC kana nyore okisijeni mask muhutano hwehutano, kurapwa kunowanzoongororwa chete ne "peripheral arterial oxygen saturation" (SpO2) kukosha uchishandisa pulse oximeter.Nekuvandudzwa kweanemia, kutarisira kwakasimba kwemurwere kunokurudzirwa, pasinei neSpO2, PaO2 uye zvinyorwa zveokisijeni muropa reropa.Mukuwedzera, Downes et al.uye Beasley et al.Izvo zvave zvataurwa kuti varwere vasina kugadzikana vanogona kunge vari pangozi nekuda kwekushandiswa kweprophylactic kweyakanyanya kuwedzera oksijeni therapy [21-24].Munguva yekuderera kwemuviri, varwere vanowana yakanyanya kuomeswa kurapwa kweokisijeni vachave nepamusoro pulse oximeter kuverenga, iyo inogona kuvhara zvishoma nezvishoma kuderera kweP / F reshiyo uye nekudaro haigone kuzivisa vashandi panguva yakakodzera, zvichikonzera kuparara kuri kuuya kunoda kupindira kwemagetsi.rutsigiro.Zvaimbofungidzirwa kuti yakakwirira FiO2 inopa dziviriro uye kuchengeteka kune varwere, asi dzidziso iyi haishandi kune kliniki yekumisikidza [14].
Nokudaro, kutarisirwa kunofanira kutorwa kunyange kana uchinyora okisijeni munguva yeperioperative kana mumatanho ekutanga ekutadza kufema.Mhedzisiro yechidzidzo ichi inoratidza kuti chiyero cheFiO2 chechokwadi chinogona kuwanikwa chete ne intubation kana HFNC.Paunenge uchishandisa LFNC kana nyore oxygen mask, prophylactic oxygen inofanira kupiwa kudzivirira kupfava kwekufema kunetseka.Midziyo iyi inogona kunge isina kukodzera kana kuongororwa kwakakomba kwechimiro chekufema kuchidikanwa, kunyanya kana mhedzisiro yeFiO2 yakakosha.Kunyangwe pakuyerera kwakaderera, FiO2 inowedzera nekuyerera kweokisijeni uye inogona kuvhara kutadza kufema.Pamusoro pezvo, kunyangwe uchishandisa SpO2 kurapwa kwepashure, zvinodikanwa kuve neakaderera kuyerera kwekuyerera sezvinobvira.Izvi zvakakosha pakuona kwekutanga kwekutadza kufema.Kuyerera kwakanyanya kweokisijeni kunowedzera njodzi yekutadza kuona nekukurumidza.Chiyero cheokisijeni chinofanirwa kutariswa mushure mekuona kuti ndeapi masaini akakosha anovandudzwa neokisijeni manejimendi.Kubva pamigumisiro yechidzidzo ichi chete, hazvikurudzirwi kushandura mafungiro ekugadzirisa oksijeni.Zvisinei, isu tinotenda kuti mazano matsva anowanikwa muchidzidzo ichi anofanirwa kutariswa maererano nenzira dzinoshandiswa mumakiriniki.Mukuwedzera, pakusarudza kuwanda kweokisijeni inokurudzirwa nemirayiridzo, zvakakosha kuisa kuyerera kwakakodzera kumurwere, pasinei neFiO2 kukosha kwemaitiro ekufemerwa kuyerera kuyerwa.
Isu tinopa pfungwa yekufunga zvakare pfungwa yeFiO2, tichifunga nezve chiyero cheokisijeni kurapa uye mamiriro ekiriniki, sezvo FiO2 iri parameter inokosha pakugadzirisa kutonga kweokisijeni.Zvisinei, chidzidzo ichi chine zvipingamupinyi zvakawanda.Kana FiO2 inogona kuyerwa mutrachea yemunhu, kukosha kwakanyanya kunogona kuwanikwa.Nekudaro, parizvino zvakaoma kuita zviyero zvakadaro pasina kuve invasive.Imwe tsvagiridzo yekushandisa isingapindire yekuyeresa michina inofanirwa kuitwa mune ramangwana.
Muchidzidzo ichi, takayera intracheal FiO2 tichishandisa iyo LFNC inongoerekana yafema simulation modhi, nyore oxygen mask, uye HFNC.Kutungamirirwa kweokisijeni panguva yekufema kunogona kukonzera kuwedzera kwekuwedzera kweokisijeni munzvimbo yakafa yeanatomical, iyo inogona kubatanidzwa nekuwedzera kwechikamu cheokisijeni inofemerwa.NeHFNC, chikamu chepamusoro cheokisijeni yakafemerwa inogona kuwanikwa kunyangwe pakuyerera kwe10 l/min.Paunenge uchitarisa huwandu hwakakwana hweokisijeni, zvinodikanwa kumisikidza chiyero chakakodzera chekuyerera kune murwere uye chaiwo mamiriro, kwete zvinoenderana chete nehunhu hwechikamu cheokisijeni yakafemeswa.Kufungidzira chikamu cheokisijeni yakafemerwa paunenge uchishandisa LFNC uye nyore okisijeni mask munzvimbo yekiriniki inogona kuve yakaoma.
Iyo data yakawanikwa inoratidza kuti kufema kwekufema kunobatanidzwa nekuwedzera kweFiO2 mutrachea yeLFNC.Pakusarudza kuwanda kweokisijeni inokurudzirwa nemirayiridzo, zvakakosha kuisa kuyerera kwakakodzera kumurwere, pasinei nehuwandu hweFiO2 hupimwa hunoshandiswa netsika yekufuridzira kuyerera.
Zvidzidzo Zvevanhu: Vese vanyori vakasimbisa kuti hapana vanhu kana matishu akabatanidzwa muchidzidzo ichi.Zvidzidzo zveMhuka: Vese vanyori vakasimbisa kuti hapana mhuka kana matishu akabatanidzwa muchidzidzo ichi.Kupesana Kwekufarira: Maererano neICMJE Uniform Disclosure Form, vanyori vose vanozivisa zvinotevera: Kubhadhara / Ruzivo Rwebasa: Vese vanyori vanotaura kuti havana kuwana rubatsiro rwemari kubva kune chero sangano rebasa rakatumirwa.Hukama Hwemari: Vese vanyori vanozivisa kuti ivo parizvino kana mukati memakore matatu apfuura vane hukama hwemari nechero sangano rinogona kufarira basa rakatumirwa.Humwe Hukama: Vese vanyori vanotaura kuti hapana humwe hukama kana zviitiko zvinogona kukanganisa basa rakatumirwa.
Tinoda kutenda VaToru Shida (IMI Co., Ltd, Kumamoto Customer Service Center, Japan) nerubatsiro rwavo nechidzidzo ichi.
Kojima Y., Sendo R., Okayama N. et al.(Chivabvu 18, 2022) Yakafemerwa mwero weokisijeni mumidziyo yakaderera uye yakanyanya kuyerera: chidzidzo chekuenzanisa.Kurapa 14(5): e25122.doi:10.7759/cureus.25122
© Copyright 2022 Kojima et al.Ichi chinyorwa chekupinda chakavhurika chakagoverwa pasi pemitemo yeCreative Commons Attribution License CC-BY 4.0.Kushandiswa kusingagumi, kugovera, uye kubereka mune chero svikiro zvinotenderwa, chero munyori wekutanga uye kwakabva vatenda.
Ichi chinyorwa chekupinda chakavhurika chakagoverwa pasi peCreative Commons Attribution License, iyo inobvumidza kushandiswa kusingarambidzwe, kugovera, uye kubereka mune chero svikiro, chero munyori uye kwaanopihwa.
(a) oxygen monitor, (b) dummy, (c) test lung, (d) anesthesia device, (e) oxygen monitor, uye (f) electric ventilator.
Zvirongwa zveventilator zvaive sezvizvi: tidal volume 500 ml, kufema kufema 10 kufema / min, inspiratory kusvika expiratory ratio (inhalation / expiration ratio) 1: 2 (nguva yekufema = 1 s).Kune zviedzo, kutevedzera mapapu ebvunzo kwakaiswa ku 0.5.
"Zvikoro" zvinoverengerwa kune yega yega oxygen kuyerera.A nasal cannula yakashandiswa kupa okisijeni kuLFNC.
Scholarly Impact Quotient™ (SIQ™) ndiyo yakasarudzika yedu yekuburitsa-yekudhindisa yekuongorora maitiro ekuongorora.Tsvaga zvimwe pano.
Ichi chinongedzo chinokuendesa kune wechitatu bato webhusaiti isina hukama neCureus, Inc. Ndokumbira utarise kuti Cureus haina mhosva kune chero zvirimo kana zviitiko zviri pane yedu shamwari kana nzvimbo dzakabatana.
Scholarly Impact Quotient™ (SIQ™) ndiyo yakasarudzika yedu yekuburitsa-yekudhindisa yekuongorora maitiro ekuongorora.SIQ™ inoongorora kukosha uye kunaka kwezvinyorwa vachishandisa huchenjeri hwakaunganidzwa hwenharaunda yese yeCureus.Vese vashandisi vakanyoreswa vanokurudzirwa kuti vabatsire kuSIQ ™ yechero chinyorwa chakaburitswa.(Vanyori havagone kuyera zvinyorwa zvavo.)
Zviyero zvepamusoro zvinofanirwa kuchengeterwa basa rechokwadi rekuvandudza muminda yavo.Chero kukosha pamusoro pe5 kunofanirwa kutariswa pamusoro peavhareji.Nepo vese vashandisi vakanyoreswa veCureus vanogona kuyera chero chinyorwa chakaburitswa, maonero enyanzvi dzezvidzidzo anotakura zvakanyanya huremu kupfuura evasiri nyanzvi.Iyo SIQ™ yechinyorwa ichaonekwa padivi pechinyorwa mushure mekunge yapihwa mwero kaviri, uye ichaverengwa patsva nechibodzwa chimwe nechimwe.
Scholarly Impact Quotient™ (SIQ™) ndiyo yakasarudzika yedu yekuburitsa-yekudhindisa yekuongorora maitiro ekuongorora.SIQ™ inoongorora kukosha uye kunaka kwezvinyorwa vachishandisa huchenjeri hwakaunganidzwa hwenharaunda yese yeCureus.Vese vashandisi vakanyoreswa vanokurudzirwa kuti vabatsire kuSIQ ™ yechero chinyorwa chakaburitswa.(Vanyori havagone kuyera zvinyorwa zvavo.)
Ndokumbira utarise kuti nekuita izvi unobvuma kuwedzerwa kune yedu yepamwedzi email tsamba yetsamba yetsamba.