-75 mmHg负压疗法对猪胸骨切开术伤口模型的血流动力学影响。
Haemodynamic effects of -75 mmHg negative pressure therapy in a porcine sternotomy wound model.
作者信息
Mokhtari Arash, Gustafsson Ronny, Sjögren Johan, Nilsson Johan, Lindstedt Sandra, Malmsjö Malin, Ingemansson Richard
机构信息
Department of Cardiothoracic Surgery, Lund University Hospital, Lund, Sweden.
出版信息
Int Wound J. 2009 Feb;6(1):48-54. doi: 10.1111/j.1742-481X.2008.00566.x.
Previous research has shown -125 mmHg to be the optimal negative pressure for creating an environment that promotes wound healing, and this has therefore been adopted as a standard pressure for patients with deep sternal wound infection. However, it has not yet been clearly shown that -125 mmHg is the optimal pressure from a haemodynamic point of view. Furthermore, there have been reports of cardiac rupture during -125 mmHg negative pressure therapy. We therefore studied the effects of a lower pressure: -75 mmHg. Twelve pigs were used. After median sternotomy, sealed negative pressure therapy of -75 mmHg was applied. Baseline measurements were made and continuous recording of the cardiac output, end-tidal CO(2) production, mean arterial pressure, mean pulmonary pressure (pulmonary artery pressure), systemic vascular resistance, pulmonary vascular resistance, left atrial pressure and central venous pressure was started. Six pigs served as controls. No statistically significant difference was observed in any of the haemodynamic parameters studied, compared with the controls. The present study shows that, with a suitable foam application technique, -75 mmHg can be applied without compromising the central haemodynamics.
先前的研究表明,-125 mmHg是营造促进伤口愈合环境的最佳负压,因此已被用作深部胸骨伤口感染患者的标准压力。然而,从血流动力学角度来看,尚未明确表明-125 mmHg就是最佳压力。此外,有报道称在-125 mmHg负压治疗期间发生了心脏破裂。因此,我们研究了较低压力(-75 mmHg)的效果。使用了12头猪。在进行正中胸骨切开术后,施加-75 mmHg的密封负压治疗。进行了基线测量,并开始连续记录心输出量、呼气末二氧化碳生成量、平均动脉压、平均肺动脉压(肺动脉压)、体循环血管阻力、肺血管阻力、左心房压和中心静脉压。6头猪作为对照。与对照组相比,在所研究的任何血流动力学参数中均未观察到统计学上的显著差异。本研究表明,采用合适的泡沫应用技术时,施加-75 mmHg的压力不会影响中心血流动力学。