Paper - WANFANG MED ONLINE

You Position: Home > Paper

呼吸道湿化的进展

( views:516, downloads:1225 )

Author:: No author available

Journal Title:: Chinese Journal of Tuberculosis and Respiratory Diseases

Issue:: 11

DOI:: 10.3760/cma.j.issn.1001-0939.2014.11.014

Key Word:: No keyword available

Abstract：保持气道内充分的湿化,是维持气道表面黏液纤毛系统正常清除功能及肺泡上皮正常特性所必需的生理条件.正常情况下,上气道对吸入气体具有生理性的湿化作用,使吸入气体在到达气管隆突下4 ～5cm水平位置时,达到100％的相对湿度,此时的绝对湿度约44 mg/L,这一水平位置也被称为等温饱和界面ISB[1].但当吸入干燥气体或吸入气流绕过上气道而直接进入下呼吸道时,特别是在有创、无创机械通气,或在保留人工气道患者自主呼吸通气时,等温饱和界面会向下气道方向位移,很容易发生呼吸道湿化不良,导致呼吸道的黏膜干燥、黏液纤毛系统功能降低,使痰液黏稠潴留,而影响呼吸系统功能[2].因此,在有创、无创机械通气,或经人工气道通气时,进行吸入气体的湿化非常重要.现将上述临床状态的气道湿化现状和研究进展综述如下.

Reference

[1]莫敏,刘松桥,杨毅.热湿交换器和加温湿化器对呼吸机相关性肺炎发生率影响的荟萃分析[J].2011,(9).
[2]Sottiaux TM.Consequences of under- and over-humidification.[J].2006,12(2).
[3]Thomas J, Kallstrom.AARC clinical practice guideline. Bland aerosol administration--2003 revision & update.[J].2003,48(5).
[4]O C, Kirton,B, DeHaven,J, Morgan,etc.A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers: rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube oc[J].1997,112.
[5]Davies MW,Dunster KR,Cartwright DW.Inspired gas temperature in ventilated neonates.[J].2004,38(1).
[6]P, Pelosi,M, Solca,I, Ravagnan,etc.Effects of heat and moisture exchangers on minute ventilation, ventilatory drive, and work of breathing during pressure-support ventilation in acute respiratory failure.[J].1996,24.
[7]M P, Shelly,G M, Lloyd,G R, Park.A review of the mechanisms and methods of humidification of inspired gases.[J].1988,14(1).
[8]Lyazidi A,Lellouche F,Maggiore SM,etc.Water content of delivered gases during non-invasive ventilation in healthy subjects.[J].2009,35(6).
[9]M, Auxiliadora-Martins,M G, Menegueti,E A, Nicolini,etc.Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients.[J].2012,45.
[10]N, Rankin.What is optimum humidity?[J].1998,4.
[11]Richard D, Branson,Michael A, Gentile.Is humidification always necessary during noninvasive ventilation in the hospital?[J].2010,55.
[12]Lefrancois F,Maggiore SM,Jouvet P,etc.Humidification performance of 48 passive airway humidifiers: comparison with manufacturer data.[J].2009,135(2).
[13]C D, Kuo,S E, Lin,J H, Wang.Aerosol, humidity and oxygenation.[J].1991,99.
[14]Kilgour E,Pack R,Rankin N,etc.Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity.[J].2004,30(7).
[15]Lellouche,F.,Pignataro,C.,Maggiore,S.M.,etc.Short-term effects of humidification devices on respiratory pattern and arterial blood gases during noninvasive ventilation[J].2012,57(11).
[16]S, INGELSTEDT.Studies on the conditioning of air in the respiratory tract.[J].1956,131.
[17]R, Williams,N, Rankin,T, Smith,etc.Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa.[J].1996,24.
[18]Ruben D, Restrepo,Brian K, Walsh.Humidification during invasive and noninvasive mechanical ventilation: 2012.[J].2012,57.
[19]Daumal F,Colpart E,Manoury B,etc.Changing heat and moisture exchangers every 48 hours does not increase the incidence of nosocomial pneumonia.[J].1999,20(5).
[20]Boles JM,Goetghebeur D,Prat G,etc.Influence of the humidification device during acute respiratory distress syndrome.[J].2003,29(12).
[21]R B, Williams.The effects of excessive humidity.[J].1998,4.
[22]R. M. HEDLEY,J. ALLT-GRAHAM.A comparison of the filtration properties of heat and moisture exchangers[J].1992,47(5).