机械性吸呼技术在有创机械通气中的应用进展

Progress in the Application of Mechanical Insufflation-Exsufflation in Invasive Mechanical Ventilation

摘要: 有创机械通气是救治重症患者的核心技术之一。自新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)疫情发生以来，有创机械通气在重症及危重症COVID-19患者中的应用日益增加。而长时间有创机械通气过程中出现的痰液滞留会影响患者的临床预后。因此，在有创机械通气过程中进行有效的松动和清除痰液是一个亟待解决的问题。机械性吸呼气技术是一种重要的辅助咳痰技术。当患者的咳嗽能力受损时，可通过模拟正常生理咳嗽来增强或放大咳嗽效应，有助于清除痰液，缩短有创机械通气时间，预防肺部感染以及减少肺部并发症，在气道清除治疗过程中具有重要的临床意义。本文对机械性吸呼技术在有创机械通气应用中的最新进展进行综述。

Abstract: Invasive mechanical ventilation is one of the core technologies in the treatment of severe patients. Since the outbreak of the novel coronavirus pneumonia epidemic, the use of invasive mechanical ventilation in severe and critically ill COVID-19 patients has been increasing. The retention of spu-tum during prolonged invasive mechanical ventilation may affect the clinical outcome of patients. Therefore, effective loosening and removal of sputum during invasive mechanical ventilation is an urgent problem. Mechanical insufflation-exsufflation is an important technique to assist expectora-tion. When patients’ cough ability is impaired, the cough effect can be enhanced or amplified by simulating normal physiological cough, which is helpful to clear sputum, shorten the time of inva-sive mechanical ventilation, prevent lung infection and reduce lung complications, and has im-portant clinical significance in the treatment of airway clearance. In this paper, the latest progress of mechanical insufflation-exsufflation in invasive mechanical ventilation is reviewed.