摘要
目的 :比较双水平压力调节 (BIPAP)通气和反比通气 (IRV)对心肺功能的影响。方法 :在两种通气模式 0、0 .5和 1.0 k Pa呼气末压 (EEP)时 ,分别测定健康犬及油酸诱发急性肺损伤犬的呼吸力学、血流动力学及血气分析各参数。结果 :无论有无急性肺损伤 ,BIPAP通气时平均气道压 (m Paw )均明显低于 IRV时(P均 <0 .0 5 )。给健康犬用 IRV通气时 ,上述 3种 EEP水平的 m Paw分别为 (0 .437± 0 .10 3) k Pa、(0 .811±0 .0 93) k Pa和 (1.36 0± 0 .119) k Pa;用 BIPAP通气时则分别降为 (0 .2 2 5± 0 .0 71) k Pa、(0 .6 11± 0 .10 5 ) k Pa和(1.10 7± 0 .0 89) k Pa。油酸诱发急性肺损伤后 ,m Paw分别由 IRV时 (0 .72 5± 0 .2 2 2 ) k Pa、(1.186± 0 .2 98) k Pa和 (1.6 0 0± 0 .10 0 ) k Pa降至 BIPAP时 (0 .35 0± 0 .12 9) k Pa、(0 .6 2 5± 0 .15 0 ) k Pa和 (1.12 5± 0 .0 96 ) k Pa;但两种通气模式中气道峰压、心排血量并无明显差异。另外 ,急性肺损伤时 ,BIPAP通气的动脉血氧分压 (Pa O2 )分别为 (9.10± 1.79) k Pa、(11.43± 1.80 ) k Pa和 (13.40± 3.2 0 ) k Pa,较 IRV时 Pa O2 (7.87± 2 .33) k Pa、(9.0 7±3.0 5 ) k Pa和 (9.71± 1.85 ) k Pa增高 (EEP 1.0 k Pa时 ,P <0 .0 5 )。结论 :
Objective:To compare the cardiopulmonary effect of pressure regulated biphasic positive airway pressure (BIPAP) and inverse ratio ventilation (IRV) on cardiac and pulmonary function.Methods:Airway pressure,hemodynamics and blood gases were measured during the two ventilatory modalities with 0,0 5, 1 0 kPa external endexpiratory pressure (EEP) in dogs with and without oleic acidinduced lung injury.Results:Airway pressure during BIPAP was lower than that with IRV with or without acute lung injury(all P <0 05 ).However,there was no difference in cardiac output.In dogs with lung injury,PaO 2 during BIPAP was higher than that during IRV.Conclusions:Compared with IRV,BIPAP can reduce the airway pressure,and improve PaO 2 in dogs with lung injury,although the cardiac output was not increased.
出处
《中国危重病急救医学》
CAS
CSCD
2002年第3期134-137,共4页
Chinese Critical Care Medicine
基金
卫生部直属医疗机构临床学科重点建设基金资助项目 ( No.CD96 / 2 6 )
关键词
人工呼吸
呼吸窘迫综合征
血流动力学
双水平压力调节通气
反比通气
mechanical respiration
respiratory distress syndrome
hemodynamics
biphasic positive airway pressure
inverse ratio ventilation
