Diagnosis and management of the pneumothoraxcomplicating mechanical ventilation

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Diagnosis and management of the pneumothoraxcomplicating mechanical ventilation

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- Diagnosis and management of the pneumothoraxcomplicating mechanical ventilation
- Journal of Chongqing Medical University Issue 2, (1997)
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  CLC： R561.4
- Published：1997，
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[1]林吉忠,张仪端.机械通气并发气胸的诊断及处理[J].重庆医科大学学报,1997(02):122-124.

Diagnosis and management of the pneumothoraxcomplicating mechanical ventilation. [J]. Journal of Chongqing Medical University (2).(1997)
[1]林吉忠,张仪端.机械通气并发气胸的诊断及处理[J].重庆医科大学学报,1997(02):122-124. DOI：

Diagnosis and management of the pneumothoraxcomplicating mechanical ventilation. [J]. Journal of Chongqing Medical University (2).(1997) DOI：

摘要

气胸是机械通气常见的并发症，在成人呼吸窘迫综合征（ＡＲＤＳ）及慢性阻塞性肺部疾病（ＣＯＰＤ）中发生率较高，分别是２９．４％和２７．８％，且多为张力性气胸。预防气胸发生的简便方法是在保证有效通气量的前提下，适当降低潮气量。机械通气过程中，患者出现血氧饱和度下降、气道压力增高、患侧呼吸音降低、心率加快及呼吸困难等临床症状均高度提示并发气胸，试穿患侧胸腔有大量气体即可诊断。安置该侧胸腔闭式引流是有效的治疗方法。

Abstract

One of the common complications in mechanical ventilation is tension pneumothorax.In this paper 164cases receiving mechanical ventilation were reviewed

and pneumothorax was foundto have high incidences inARDS and COPD.The critical factor to prevent pneumothorax was to reduce the tidal volume

but the alveolarventilation must be ensured by increasing the respiratory rates.In patients receiving mechanical ventilation

pneumothorax should be suspected if some of the following clinical manifestations appeared abruptly

e.g.

decreased blood oxygen saturation

increased airway pressure

dininished breath sound of the involved lung

tachycardia and dyspnea.The diagnosis was made by detecting the air from the pleural space by direct neelepuncture

The effective treatment was closed thoracic drainage.

关键词

机械通气气胸

Keywords

mechanical ventilationPneumothorax

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Related Institution

Department of Respiratory and Critical Care Medicine,Chinese PLA General Hospital

重庆医科大学临床学院肺科

Department of Pulmonary Diseases,College of Clinical Medicine,Chongqing Medical University

重庆医科大学临床学院急诊科

Department of Emergency,College of Clinical Medicine,Chongqing Medical Un iversity

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