Shortland D B, Field D, Archer L N, Gibson N A, Woods K L, Evans D H, Levene M I
Department of Child Health, Leicester University Medical School.
Arch Dis Child. 1989 Apr;64(4 Spec No):465-9. doi: 10.1136/adc.64.4_spec_no.465.
The effects of changes in positive end expiratory pressure (PEEP) on cerebral blood flow velocity, arterial blood gases, and mean arterial pressure were studied in newborn infants. In mechanically ventilated premature infants with severe respiratory disease, an increase in PEEP from 2 to 6 cm H2O was associated with an increase in cerebral blood flow velocity. There was no significant change in mean arterial blood pressure. There was a significant increase in PaO2 and PaCO2 for every stepwise rise in PEEP. Multivariate regression analysis showed that 72% of the effect on cerebral blood flow velocity was attributable to PaCO2 alone and that any change in blood pressure was not likely to contribute to these changes. There was no evidence that changes in PEEP within the commonly used range adversely affected the neonatal cardiovascular or cerebral circulations.
在新生儿中研究了呼气末正压（PEEP）变化对脑血流速度、动脉血气和平均动脉压的影响。在患有严重呼吸系统疾病的机械通气早产儿中，PEEP从2 cm H₂O增加到6 cm H₂O与脑血流速度增加相关。平均动脉血压无显著变化。随着PEEP的每一步升高，动脉血氧分压（PaO₂）和动脉血二氧化碳分压（PaCO₂）均显著升高。多变量回归分析表明，对脑血流速度的影响中72%仅归因于PaCO₂，血压的任何变化都不太可能导致这些变化。没有证据表明在常用范围内PEEP的变化会对新生儿心血管或脑循环产生不利影响。
