切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2026, Vol. 12 ›› Issue (01) : 21 -24. doi: 10.3877/cma.j.issn.2096-1537.2026.01.004

专题笔谈

慢病人群呼吸机依赖的现状及适宜干预策略
袁雪燕, 陈辉, 刘玲()   
  1. 210009 南京,江苏省重症医学重点实验室 东南大学附属中大医院重症医学科
  • 收稿日期:2025-09-16 出版日期:2026-02-28
  • 通信作者: 刘玲
  • 基金资助:
    四大慢病重大专项(2024ZD0530000,2024ZD0530004); 国家自然科学基金项目(82270083,82470079); 江苏省前沿技术研发计划项目(BF2024054); 江苏省“333高层次人才培养工程”项目(LGY2022025); 江苏省重点实验室项目(ZDXYS202205)

Current status and appropriate intervention strategies for prolonged mechanical ventilation in patients with chronic diseases

Xueyan Yuan, Hui Chen, Ling Liu()   

  1. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2025-09-16 Published:2026-02-28
  • Corresponding author: Ling Liu
引用本文:

袁雪燕, 陈辉, 刘玲. 慢病人群呼吸机依赖的现状及适宜干预策略[J/OL]. 中华重症医学电子杂志, 2026, 12(01): 21-24.

Xueyan Yuan, Hui Chen, Ling Liu. Current status and appropriate intervention strategies for prolonged mechanical ventilation in patients with chronic diseases[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2026, 12(01): 21-24.

呼吸机依赖是慢性疾病(简称慢病)患者预后不良的主要原因,已成为重要的公共健康问题。慢病患者呼吸机依赖的风险因素复杂且不断变化,因缺乏智能预测模型,难以提前识别高危人群并进行精准干预,慢病患者呼吸机依赖发生率及病死率均较高。通过自动提取与融合呼吸、脑、心、膈肌及内分泌等多维度器官功能特征,构建自适应优化预测模型,形成兼具普适性与特异性的智能化表型预测体系。在此基础上,开发模块化、临床表型导向的干预策略,并依托高频数据反馈与虚拟现实技术,构建覆盖有创及无创呼吸支持的智慧化康复平台。通过进一步制定从呼吸支持到远期康复的全周期诊疗路径,形成“监测-反馈-干预”闭环,推动我国呼吸康复诊疗体系从传统经验模式向数据驱动、个体化、智能化的新范式转型。

Prolonged mechanical ventilation is a major cause of poor prognosis in patients with chronic diseases and has become a significant public health issue. The risk factors for prolonged mechanical ventilation in chronic disease patients are complex and constantly changing. Due to the lack of intelligent prediction models, it is difficult to identify high-risk populations in advance and provide precise interventions, resulting in high incidence and mortality rates of prolonged mechanical ventilation among these patients. By automatically extracting and integrating multidimensional organ functional features-including respiratory, neurological, cardiac, diaphragmatic, and endocrine metrics-an adaptive, optimized predictive model is constructed to form an intelligent phenotype prediction system that balances universality with specificity. Based on this, modular and clinical phenotype-oriented intervention strategies are developed. Furthermore, by leveraging high-frequency data feedback and virtual reality technology, an intelligent respiratory rehabilitation platform is built to cover both invasive and non-invasive support. The establishment of a full-cycle clinical pathway, extending from initial respiratory support to long-term rehabilitation, creates a "monitoring-feedback-intervention" closed loop, driving the transformation of the respiratory rehabilitation system from a traditional experience-based model toward a new, data-driven, individualized, and intelligent paradigm.

1
Liu L, Yang Y, Gao Z, et al. Practice of diagnosis and management of acute respiratory distress syndrome in Mainland China: a cross-sectional study [J]. J Thorac Dis, 2018, 10(9): 5394-5404.
2
Pham T, Heunks L, Bellani G, et al. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study [J]. Lancet Respir Med, 2023, 11(5): 465-476.
3
Liu L, Gao Z, Yang Y, et al. Economic variations in patterns of care and outcomes of patients receiving invasive mechanical ventilation in China: a national cross-sectional survey [J]. J Thorac Dis, 2019, 11(7): 2878-2889.
4
Li J, Zhan QY, Wang C. Survey of prolonged mechanical ventilation in intensive care units in Mainland China [J]. Respir Care, 2016, 61(9): 1224-1231.
5
Rose L, Messer B. Prolonged mechanical ventilation, weaning, and the role of tracheostomy [J]. Crit Care Clin, 2024, 40(2): 409-427.
6
Damuth E, Mitchell JA, Bartock JL, et al. Long-term survival of critically ill patients treated with prolonged mechanical ventilation: a systematic review and Meta-analysis [J]. Lancet Respir Med, 2015, 3(7): 544-553.
7
Jacobs JM, Marcus EL, Stessman J. Prolonged mechanical ventilation: a comparison of patients treated at home compared with hospital long-term care [J]. J Am Med Dir Assoc, 2021, 22(2): 418-424.
8
D'Cruz RF, Kaltsakas G, Suh ES, et al. Quality of life in patients with chronic respiratory failure on home mechanical ventilation [J]. Eur Respir Rev, 2023, 32(168): 220237.
9
Na S, Ko R, Nam J, et al. Factors associated with prolonged weaning from mechanical ventilation in medical patients [J]. Ther Adv Respir Dis, 2022, 16: 17534666221117005.
10
Villar J, González-Martín JM, Fernández C, et al. Predicting the length of mechanical ventilation in acute respiratory disease syndrome using machine learning: the PIONEER study [J]. J Clin Med, 2024, 13(6): 1811.
11
Heunks LM, van der Hoeven JG. Clinical review: the ABC of weaning failure--a structured approach [J]. Crit Care, 2010, 14(6): 245.
12
Zilberberg MD, Nathanson BH, Ways J, et al. Characteristics, hospital course, and outcomes of patients requiring prolonged acute versus short-term mechanical ventilation in the United States [J]. Crit Care Med, 2020, 48(11): 1587-1594.
13
TEAM Study Investigators and the ANZICS Clinical Trials Group; Hodgson CL, Bailey M, Bellomo R, et al. Early active mobilization during mechanical ventilation in the ICU [J]. N Engl J Med, 2022, 387(19): 1747-1758.
14
Perren A, Brochard L. Managing the apparent and hidden difficulties of weaning from mechanical ventilation [J]. Intensive Care Med, 2013, 39(11): 1885-1895.
15
Trudzinski FC, Neetz B, Dahlhoff JC, et al. A multidimensional approach to the management of patients in prolonged weaning from mechanical ventilation: the concept of treatable traits-a narrative review [J]. Respiration, 2025, 104(4): 240-254.
16
Huebner L, Warmbein A, Scharf C, et al. Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: prospective interventional cohort study with retrospective control group analysis [J]. Crit Care, 2024, 28(1): 112.
17
Viderman D, Ayazbay A, Kalzhan B, et al. Artificial intelligence in the management of patients with respiratory failure requiring mechanical ventilation: a scoping review [J]. J Clin Med, 2024,13(24): 7535.
18
Bhatt SP, Westra J, Kuo YF, et al. Pulmonary rehabilitation utilization in older adults with chronic obstructive pulmonary disease, 2013-2019 [J]. Ann Am Thorac Soc, 2024, 21(5): 740-747.
19
陈雨莎, 姜宏英, 童朝晖. 呼吸康复年度进展2024 [J]. 中华结核和呼吸杂志, 2025, 48(1): 89-93.
[1] 张亚琼, 张雨霖, 丁科, 张晓霞, 胡文佳, 陈铁龙, 宋世会, 熊勇. 人类免疫缺陷病毒感染/获得性免疫缺陷综合征患者接受抗反转录病毒治疗四年后发生免疫重建不全的风险预测模型[J/OL]. 中华实验和临床感染病杂志(电子版), 2025, 19(06): 335-344.
[2] 贺智恒, 姚德炯, 孙东方. 腹腔镜下胆囊切除术后胆瘘影响因素分析及风险预测模型的构建[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(02): 175-178.
[3] 罗仲燃, 曾智豪, 黄梦娟, 何晓艺. 乳腺癌术后腋窝淋巴结负荷的多因素分析及预测模型的建立及验证[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(01): 46-50.
[4] 邓瑞锋, 程璐, 刘远灵, 郑秋平, 刘溪, 江文聪, 江敏耀, 习明. 基于Logistic回归构建一期输尿管通路鞘置入失败的预测模型[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(02): 171-178.
[5] 谷瑞辰, 林福杨, 刘永达. 术前尿培养阴性患者PCNL术后尿路感染的预测模型构建[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(06): 772-777.
[6] 王小振, 陈灿辉, 唐善华, 代浩嘉, 丰扬舸, 王恺, 李清平, 李川江. 基于不同机器学习技术构建肝移植术后早期严重并发症预测模型和效能比较[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(02): 197-204.
[7] 黄少坚, 梁汉标, 李清平, 唐善华, 李青妍, 李芷西, 黄灿, 王小振, 陈灿辉, 王恺, 李川江. 基于影像组学和临床特征构建肝癌新辅助/转化治疗后病理学完全缓解预测模型[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(06): 860-867.
[8] 罗钰莹, 陈洁. 慢病人群呼吸机依赖精准干预体系的构建及实施路径[J/OL]. 中华重症医学电子杂志, 2026, 12(01): 25-30.
[9] 黄絮. 慢病呼吸机依赖高危人群的特征及其危险因素[J/OL]. 中华重症医学电子杂志, 2026, 12(01): 31-36.
[10] 李绪言, 刘双林, 管鲁家, 童朝晖. 基于慢病呼吸机依赖患者的智慧化呼吸康复平台探索:科技赋能呼吸康复[J/OL]. 中华重症医学电子杂志, 2026, 12(01): 37-41.
[11] 张容, 许家璇, 叶伟炎, 刘学松, 刘晓青. 以慢病为核心的呼吸机依赖预测探索:从表型多样到人工智能赋能[J/OL]. 中华重症医学电子杂志, 2026, 12(01): 42-45.
[12] 王超, 张晓会, 李晓帆, 赵海丹. 维持性血液透析患者感染与心脑血管死亡风险的比较及联合预测模型构建[J/OL]. 中华临床医师杂志(电子版), 2025, 19(09): 675-681.
[13] 郭岩, 赵灵芝, 石光英. 代谢相关脂肪性肝病患者发生冠心病的风险预测模型[J/OL]. 中华临床医师杂志(电子版), 2025, 19(09): 682-688.
[14] 皇立媛, 浦洁, 王苏贵, 陈婷婷, 朱德慧, 胡雪. 中青年脑卒中患者应激障碍风险预测模型的构建与验证[J/OL]. 中华临床医师杂志(电子版), 2025, 19(07): 504-512.
[15] 徐璐, 刘晶莹, 李梦莹, 黄菊, 谈慧颖. 肺癌患者胸腔镜术后肺部感染预测模型的构建与比较[J/OL]. 中华胸部外科电子杂志, 2026, 13(01): 49-55.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?