Vpliv podajnosti prilagodljivih anestezijskih dihalnih sistemov na doveden dihalni volumen

Karnjuš, Igor

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Title:	Vpliv podajnosti prilagodljivih anestezijskih dihalnih sistemov na doveden dihalni volumen
Authors:	ID Karnjuš, Igor (Author) ID Križmarić, Miljenko (Mentor) More about this mentor... ID Mekiš, Dušan (Comentor) ID Pajnkihar, Majda (Comentor)
Files:	MAG_Karnjus_Igor_2010.pdf (1,28 MB) MD5: 1E6345D068B5628ABCC4B17FE9881A31 PID: 20.500.12556/dkum/78f2d888-1fff-4c40-b558-32befddd548e
Language:	Slovenian
Work type:	Master's thesis/paper
Organization:	FZV - Faculty of Health Sciences
Abstract:	Za prilagodljive anestezijske dihalne sisteme je značilno, da se njihova dolžina lahko spreminja, vendar še ni povsem jasno, ali sprememba njihove dolžine vpliva na natančnost dovajanja dihalnih volumnov bolniku med mehansko ventilacijo. Zato je bil namen raziskave proučiti vpliv dolžine prilagodljivih anestezijskih dihalnih sistemov na njihovo podajnost in s tem na natančnost dovajanja dihalnih volumnov med mehansko ventilacijo ter tako ugotoviti pomen načina umerjanja, ki jo anestezijska medicinska sestra opravlja v klinični praksi. Raziskovalna metodologija: S telefonsko poizvedbo je bil ugotovljen način umerjanja prilagodljivih anestezijskih dihalnih sistemov v kliničnem okolju. Podajnost prilagodljivih anestezijskih dihalnih sistemov smo analizirali s pomočjo leak/compliance testa (180 meritev) na dolžinah popolnoma skrčen, raztegnjen na polovico in popolnoma raztegnjen anestezijski dihalni sistem na treh anestezijskih aparatih. Pri ugotavljanju vpliva testne dožine in dolžine prilagodljivih anestezijskih dihalnih sistemov med mehansko ventilacijo na dovedene dihalne volumne je bil anestezijski aparat povezan z mehanskim simulatorjem pljuč. Dihalne volumne smo merili na nivoju simulatorja mehanskih pljuč in na nivoju ekspiracijske zaklopke anestezijskega aparata. Izmerjene dihalne volumne smo primerjali z nastavljenimi volumni na anestezijskem aparatu (200 ml, 300 ml, 600 ml in 800 ml). Rezultati: V klinični praksi dolžina, na kateri so prilagodljivi anestezijski dihalni sistemi umerjeni, ni vedno enaka dolžini, s katero se bolnika med operativnim posegom predihuje. Podajnost prilagodljivega anestezijskega dihalnega sistema se spreminja z njegovo dolžino (p<0,05), le-ta pa vpliva na dihalne volumne, ki jih med mehansko ventilacijo anestezijski aparat dovaja do bolnika. Največja odstopanja med nastavljenimi dihalnimi volumni in izmerjenimi volumni na nivoju mehanskega simulatorja pljuč so bila, ko je bil anestezijski dihalni sistem umerjen na dolžini popolnoma skrčen, mehanska ventilacija pa izvajana z dolžino popolnoma raztegnjen anestezijski dihalni sistem, in sicer 14,08%. Zaključki: Sodobni anestezijski aparati, ki vsebujejo sistem kompenzacije podajnosti, dobro uravnavajo spremembo podajnosti prilagodljivih anestezijskih dihalnih sistemov, čeprav le-ta vpliva na natančnost dovajanja dihalnih volumnov. Na podlagi naših ugotovitev lahko zaključimo, da je potrebno, da anestezijske medicinske sestre prilagodljivi anestezijski dihalni sistem umerjajo na dolžini, kot bo uporabljena med operativnim posegom.
Keywords:	prilagodljivi anestezijski dihalni sistem, kompenzacija podajnosti, anestezijska medicinska sestra
Place of publishing:	Maribor
Publisher:	[I. Karnjuš]
Year of publishing:	2010
PID:	20.500.12556/DKUM-16836
UDC:	615.4:616-089.5
COBISS.SI-ID:	1654180
NUK URN:	URN:SI:UM:DK:DITVPWQA
Publication date in DKUM:	07.12.2010
Views:	3629
Downloads:	579
Metadata:
Categories:	FZV
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Secondary language

Language:	English
Title:	The Effect of Adjustable Anesthesia Breathing Systems Compliance on Delivered Tidal Volume
Abstract:	The main characteristic of the adjustable anaesthesia breathing system is the possibility of adjustable length, but it has not yet been ascertained whether the change in length influences the accuracy in delivering tidal volume to the patient during mechanical ventilation. The purpose of our research was to investigate the influence of different breathing system lengths to their compliance and, simultaneously, to measure the accuracy in delivering the tidal volume in order to determine the importance of the adjustable anaesthesia breathing system calibration method performed by anaesthetics nurses. Research methodology: A telephone survey was used to explore the calibration methods of the adjustable anaesthesia breathing systems in use in clinical settings. The adjustable anaesthesia breathing system compliance was analysed with a leak/compliance test (180 measurements) with fully compressed, half compressed and fully extended breathing system on 3 anaesthesia machines. The influences of the adjustable anaesthesia breathing system length (during the test procedure and during mechanical ventilation) on delivered tidal volumes were assessed with the circuit system, connected to a mechanical lung simulator. Tidal volumes were measured at the level of the mechanical lung and at the expiratory valve of the anaesthesia machine. Delivered tidal volumes were compared to different volumes set on the anaesthesia machine (200, 300, 600 and 800 ml). Results: In practice, the adjustable anaesthesia breathing system is not always tested at the length at which the patient is ventilated during the operation. Its compliance changes according to the length (p<0,05) which influences the tidal volumes delivered by the anaesthesia machine to the patient. The largest inconsistencies between set tidal volumes and delivered tidal volumes at the mechanical lung level (14.08%) occurred when the adjustable anaesthesia breathing system was tested fully compressed and the mechanical ventilation was performed with fully extended anaesthesia breathing system. Conclusions: New generations of anaesthesia machines that use compliance compensation are capable of compensating the changes in the compliance of the adjustable anaesthesia breathing system, although the results demonstrated that the compliance has an influence on the accuracy of delivering tidal volumes. According to our findings anaesthetics nurses should calibrate the adjustable anaesthesia breathing system at the length used during the operation.
Keywords:	adjustable anaesthesia breathing system, compliance compensation, anaesthetics nurses

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