摘要
在高频喷射通气（ＨＦＪＶ）治疗犬实验性急性呼吸窘迫综合征（ＡＲＤＳ）时，采用连续ＨＦＪＶ基础上间歇叠加深吸气（ＨＦＪＶ＋ＤＩ）的新通气方法，以期为ＡＲＤＳ的治疗寻找一种新途径。用油酸复制犬ＡＲＤＳ模型，并随机分为３组。ＨＦＪＶ＋ＤＩ组（ｎ＝１０）：在连续ＨＦＪＶ基础上每隔１０分钟加入１次深吸气；常规机械通气组（ＣＭＶ，ｎ＝１０），给予０．７８５ｋＰａ（１ｋＰａ＝１０．２０ｃｍＨ２Ｏ）呼气末正压（ＰＥＥＰ）治疗；对照组（ｎ＝１０），未予通气治疗。每隔１小时测定１次氧合及血流动力学指标，共观察５小时。注射油酸后，动脉氧分压（ＰａＯ２）由１２．４００ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）降至６．５６０ｋＰａ（Ｐ＜０．０１），动脉二氧化碳分压（Ｐａ－ＣＯ２）未见明显变化。通气治疗后，ＣＭＶ和ＨＦＪＶ＋ＤＩ均使ＰａＯ２明显升高，ＰａＣＯ２无明显变化（Ｐ＞０．０５），ＨＦＪＶ＋ＤＩ的氧释放指数（ＤＯ２Ｉ）明显高于ＣＭＶ组（Ｐ＞０．０５），心脏指数（ＣＩ）在ＣＭＶ组及ＨＦＪＶ＋ＤＩ组均明显减低（Ｐ＜０．０５）。提示：ＨＦＪＶ＋ＤＩ时ＰａＯ２的提高大于ＣＩ下降所致的不利影响。
In order to seek a new method of ventilation for acute respiratory distress syndrome (ARDS),cardiopulmonary effects of high frequency jet ventilation with deep inspiration (HFJV+DI) and conventional mechanical ventilation(CMV) on oleic acid induced RDS in dogs were studied.30 dogs were divided into three groups after oleic acid injection.All cardiopulmonary data were recorded hourly during HFJV+DI(n=10)with a deep inspiration per 10 minutes.In CMV group(n=10),positive end expiratory pressure was employed PEEP,0 785kPa(1kPa=10 20cmH 2O) .In controls (n=10),no ventilation was given.Oxygenation and hemodynamic data were observed once a hour for five hours.After oleic acid injection,PaO 2 decreased from 12 40kPa(1kPa=7 5mmHg) of base line to 6 56kPa( P <0 01),but PaCO 2 was not found to have any significant change.After ventilation,PaO 2 increased significantly and cardiac index (CI) decreased significanty ( P <0 05)in bcty CMV and HFJV+DI groups but PCO 2 remained unchanged( P >0 05).The values of oxygen delivery index (DO 2I) and CI were greater in HFJV+DI group than CMV group.It is suggested that the advantage of PaO 2 increase outweighs the disadvantage of CI decrease during HFJV+DI,and hence,HFJV+DI is superior to CMV with PEEP in terms of tissue oxygenation.
出处
《中国危重病急救医学》
CAS
CSCD
1996年第4期207-209,共3页
Chinese Critical Care Medicine
关键词
呼吸窘迫综合征
高频喷射通气
呼气末正压
acute respiratory distress syndrome
high frequency jet ventilation
positive end expiratory pressure
oxygen delivery
