开胸手术期间对下垂肺实施选择性呼气末正压通气可改善氧合。

Improved oxygenation during thoractomy with selective PEEP to the dependent lung.

作者信息

Brown D R, Kafer E R, Roberson V O, Wilcox B R, Murray G F

出版信息

Anesth Analg. 1977 Jan-Feb;56(1):26-31. doi: 10.1213/00000539-197701000-00009.

DOI:10.1213/00000539-197701000-00009

PMID:319703

Abstract

In 22 patients during thoracotomy in the lateral position, the effects of selective positive end-expiratory pressure (PEEP) to the dependent lung while simultaneously ventilating the non-dependent lung at zero end-expiratory pressure (ZEEP) on (1) inspired O2 concentration required to maintain adequate Pao2 during thoractomy and 2) alveolar-arterial oxygen difference (AaO2D) while breathing 100 percent O2 at the end of thoractomy were examined and compared to ventilation of both lungs at ZEEP, Selective PEEP to the dependent lung resulted in adequate PaO2 with a lower inspired O2 concentration (44 +/- SD 6% versus 70 +/- SD 21%), and a smaller AsO2D while breathing 100 percent O2 189 +/- SD 31 versus 342 +/- SD 69 torr) at the end of thoracotomy.

摘要

在22例侧卧位开胸手术患者中，研究了对依赖侧肺施加选择性呼气末正压（PEEP），同时对非依赖侧肺以零呼气末压（ZEEP）进行通气，对以下两方面的影响：（1）开胸手术期间维持足够动脉血氧分压（PaO2）所需的吸入氧浓度；（2）开胸手术结束时呼吸100%氧气时的肺泡-动脉氧分压差（AaO2D），并与双肺均采用ZEEP通气进行比较。对依赖侧肺施加选择性PEEP可在较低的吸入氧浓度下维持足够的PaO2（44±标准差6% 对比70±标准差21%），且在开胸手术结束时呼吸100%氧气时AaO2D更小（189±标准差31对比342±标准差69托）。