Clinical Experience with Smart Care for Respiratory Managementafter Esophageal Cancer Surgery
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概要
- 論文の詳細を見る
Smart Care ® (SC) is an automated weaning system which has been newly installed in the Evita XL Ventilator made by Dräger Medical (Lubeck, Germany). This study was performed to investigate the application of SC to postoperative respiratory management in patients with esophageal cancer, for the purpose of more objectively assessing postoperative weaning from the ventilator, which has largely been performed based on the individual physicians experience. This study included 8 patients with cancer of the thoracic esophagus who were weaned postoperatively from the ventilator using SC. The weaning was performed by adjusting the ventilator automatically using SC to decrease the preset pressure support (PS) level to 7 cmH2O, using spontaneous respiratory rate (F spont), expiratory tidal volume (Vte) and end-tidal carbon dioxide pressure (etCO2) as the assessment factors under the conditions of continuous positive airway pressure (CPAP) mode and a positive end expiratory pressure (PEEP) of 5 cm or less. In all 8 patients, weaning was accomplished with the display of the message "Consider Separation", in accordance with which the endotracheal tube was removed. The mean duration of intubation was 32 ± 4.0 hours, and that of SC use was 104.4 ± 42.8 minutes. SC proved remarkably useful in that all the patients had an uneventful course after the removal of the endotracheal tube and none required reintubation. It is expected in the future that the use of SC will enable the establishment of a uniform weaning protocol after esophageal cancer surgery, and this may contribute to the standardization and higher efficiency of postoperative respiratory management.
著者
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NARITAKA YOSHIHIKO
Department of Surgery, Tokyo Women's Medical University, Daini Hospital
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SHIMAKAWA TAKESHI
Department of Surgery, Tokyo Women's Medical University, Daini Hospital
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Shiozawa Shunichi
Department Of Gastroenterology And Hepatology Shimane University School Of Medicine
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Asaka Shinichi
Department Of Surgery Tokyo Women's Medical University Daini Hospital
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Murayama Minoru
Department Of Dermatology And Occupational Dermatopathology University Of Occupational And Environme
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Yamaguchi Kentaro
Department Of Pharmaceutical Technology Faculty Of Pharmaceutical Sciences At Kagawa Campus Tokushim
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Ogawa Kenji
Department Of Applied Biological Chemistry Faculty Of Agriculture Shizuoka University
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SHIOZAWA Shunichi
Department of Surgery, Tokyo Women's Medical University Medical Center East
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Isohata Noriyuki
Department of Surgery, Tokyo Women's Medical University Medical Center East
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Katsube Takao
Department of Surgery, Tokyo Women's Medical University Medical Center East
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Shimakawa Takeshi
Department of Surgery, Tokyo Women's Medical University Medical Center East
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Naritaka Yoshihiko
Department of Surgery, Tokyo Women's Medical University Medical Center East
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