Jardin F, Delorme G, Hardy A, Auvert B, Beauchet A, Bourdarias J P
Intensive Care Unit, Hôpital Ambroise Paré, Boulogne, France.
Anesthesiology. 1990 Jun;72(6):966-70. doi: 10.1097/00000542-199006000-00003.
To examine the cyclic changes in right ventricular (RV) function induced by controlled ventilation, right heart catheterization and two-dimensional echocardiography were combined in a group of 20 patients requiring respiratory support for an episode of acute respiratory failure. Simultaneous measurements of RV pressure (using a modified pulmonary artery catheter), RV stroke output (thermodilution), and RV dimensions (two-dimensional echocardiography), permitted a beat to beat evaluation of RV function throughout the mechanical respiratory cycle. When compared with expiration, lung inflation produced an increase in RV systolic pressure and volume, an increase in RV diastolic volume with an unchanged RV diastolic pressure, and a marked decrease in RV ejection fraction. It is concluded that controlled ventilation altered RV function primarily by increasing RV afterload during the lung inflation period.
为了研究控制通气引起的右心室（RV）功能的周期性变化，对20例因急性呼吸衰竭发作而需要呼吸支持的患者，联合应用右心导管检查和二维超声心动图。同时测量右心室压力（使用改良的肺动脉导管）、右心室每搏输出量（热稀释法）和右心室尺寸（二维超声心动图），从而能够在整个机械呼吸周期中逐搏评估右心室功能。与呼气时相比，肺充气使右心室收缩压和容积增加，右心室舒张容积增加而右心室舒张压不变，且右心室射血分数显著降低。得出的结论是，控制通气主要通过在肺充气期增加右心室后负荷来改变右心室功能。
