摘要
目的 探讨反比通气 (IRV)对急性呼吸窘迫综合征 (ARDS)绵羊血流动力学及氧代谢的影响。方法 总呼气末正压 (PEEPt)相同条件下 ,观察压力控制 (PC) /容量控制 (VC)正比和反比通气 (IRV)对血流动力学及氧代谢的影响。结果 与VC及VC IRV比较 ,PC及PC IRV时的气道峰值压力明显降低。但IRV时的平均气道压力明显高于正比通气 (P <0 0 5 )。VC IRV与VC及PC IRV与PC比较 ,血流动力学及氧代谢均无明显差异。实施PC IRV时 ,内源性呼气末正压为 (3 0± 1 0 )cmH2 O ,显著高于VC (2 1± 0 8)cmH2 O(P <0 0 5 )。PEEPt相同的前提下 ,PC IRV时动脉血氧饱和度 (SaO2 )为 90 % ,显著低于VC(96 % ) (P <0 0 5 )。结论 在PEEPt相同的前提下 ,无论是VC IRV还是PC IRV ,均不优于常规正比通气。
Objective To observe the effect of inverse ratio ventilation (IRV) on hemodynamics and oxygen metabolism in sheep with acute respiratory distress syndrome (ARDS). Methods Twelve ARDS sheep induced by LPS were admitted to this study,and received mechanical ventilation with volume controlled (VC) and pressure controlled ventilation (PC) (conventional ratio and inverse ratio) at the same level of total positive end expiratory pressure (PEEPt),data of hemodynamics and oxygen metabolism were collected at 30 min after the onset of each mode. Results With PC,peak airway pressure was lower than that with VC,but mean airway pressure was higher with IRV. At the same level of PEEPt,there was no difference in hemodynamics and oxygen metabolism between VC and VC IRV,same as PC and PC IRV But compared with VC,arterial oxygen pressure and arterial oxygen saturation with PC IRV were lower significantly ( P <0 05). Conclusion PEEPt was a very important factor to improve oxygenation,short term IRV was not better than VC or PC
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2001年第4期228-230,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
急性呼吸窘迫综合征
机械通气
血流动力学
氧代谢
Acute respiratory distress syndrome
Mechanical ventilation
Hemodynamics
Oxygen metabolism
