基于呼吸力学监护仪闭环反馈系统下不同镇静方案在机械通气患者中的应用OA

Objective To investigate the application effects of different sedation regimens under closed-loop feedback system based on respiratory mechanics monitor in patients undergoing mechanical ventilation.Methods The clinical data of 100 patients undergoing mechanical ventilation admitted to our hospital from January 2023 to January 2026 were retrospectively analyzed.They were divided into the control group and the study group according to the sedation regimen.Both groups received continuous analgesia with remifentanil,and the sedation depth was adjusted with the assistance of the closed-loop feedback system of respiratory mechanics monitor.The control group was additionally given midazolam injection,while the study group was additionally given remimazolam tosilate.The sedation-related indicators,respiratory mechanics parameters,blood gas analysis indicators,inflammatory and oxidative stress indicators and occurrence of adverse events were compared between the two groups.Results The time to achieve target sedation,time to awakening after drug withdrawal and extubation time in the study group were shorter than those in the control group,and the frequency of remedial sedation was less than that in the control group(P＜0.05).At 2 h,6 h,12 h and 24 h after administration,the plateau pressure and airway resistance in the study group were lower than those in the control group,and the static lung compliance was significantly higher than that in the control group(P＜0.05).At 24 h after administration,the arterial partial pressure of oxygen(PaO2)and arterial oxygen saturation(SaO2)in the study group were higher than those in the control group(P＜0.05).At 24 h after administration,the levels of malondialdehyde(MDA),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the control group,and the level of superoxide dismutase(SOD)was higher than that in the control group(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusions Under the closed-loop feedback system based on respiratory mechanics monitor,the remimazolam combined with remifentanil regimen is superior to the midazolam combined with remifentanil regimen in terms of sedation efficiency,improvement of respiratory mechanics and control of inflammatory response,with comparable safety.