摘要
目前临床上倾向于使用多种辅助工具进行呼吸功能监测来发现多种临床场景中的呼吸相关不良事件。综合肺指数(integrated pulmonary index,IPI)是一种新型医用呼吸功能监测工具,基于模糊逻辑数学模型,将反映患者呼吸状态的4个参数[P_(ET)CO_(2)、呼吸频率(respiratory rate,RR)、SpO_(2)、脉搏(pulse,PR)]进行整合,简化为范围从1(严重呼吸功能不全)到10(最佳呼吸状态)的单一值,实时反映患者的氧合和通气情况。文章从IPI监测的算法、临床应用(评估在程序化镇静、PACU、术后监护病房及急诊中患者的呼吸功能)及其不足进行阐述。IPI以简单、清晰的方式将患者的呼吸状态提供给医护人员,帮助医护人员在较短时间内做出判断并进行干预,对于减少呼吸相关不良事件具有一定优势,但其更多的益处以及临床常规应用仍需进一步研究支持。
At present,a variety of auxiliary tools tend to be used for respiratory monitoring,and respiratory⁃related adverse events in various clinical scenarios are found.It is challenging for different clinicians to comprehensively analyze the values of multiple respiratory function test indicators and give a correct interpretation.Integrated pulmonary index(IPI)is a new respiratory monitoring tool for medical use.Based on a fuzzy logic mathematical model,it integrates and simplifies four parameters of the patient's respiratory status:end⁃tidal carbon dioxide partial pressure(P_(ET)CO_(2)),respiratory rate(RR),blood oxygen saturation(SpO_(2)),and pulse(PR)into a single parameter ranging from 1(severe respiratory insufficiency)to 10(optimal breathing state),reflecting the patient's continuous oxy⁃genation and ventilation in real⁃time.This review mainly describes the algorithm,clinical application of IPI monitoring[assessing the respiratory function of patients in programmed sedation period,post⁃anesthesia care unit(PACU),postoperative care unit,and emergen⁃cy department],and deficiencies of the IPI monitoring.IPI provides the patient's clear and simplified respiratory status to medical staff to make judgments and intervene in a short time.It has certain advantages in reducing respiratory⁃related adverse events,but its other benefits and routine clinical applications still need further research.
作者
张迪
何龙
田丹丹
刘梦菲
许颖
秦菲菲
艾艳秋
Zhang Di;He Long;Tian Dandan;Liu Mengfei;Xu Ying;Qin Feifei;Ai Yanqiu(Department of Anesthesiology,Pain and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《国际麻醉学与复苏杂志》
CAS
2022年第7期743-747,共5页
International Journal of Anesthesiology and Resuscitation
关键词
呼吸监测
综合肺指数
镇静
不良事件
机械通气
Respiration monitoring
Integrated pulmonary index
Sedation
Adverse event
Mechanical ventilation
