Hausdorf G, Hellwege H H
Crit Care Med. 1987 Jul;15(7):661-4. doi: 10.1097/00003246-198707000-00007.
Because determining cardiac output is difficult in premature infants, little is known about the hemodynamic effects of PEEP in this age group. We used pulsed-wave Doppler echocardiography to assess the hemodynamic effects of PEEP increments in ten premature infants with respiratory distress syndrome. At a PEEP of 4 cm H2O, the systemic and pulmonary blood flow and the right (SVRV) and left (SVLV) ventricular stroke volume decreased slightly, while the systemic vascular resistance (Rs) increased slightly. At a PEEP of 8 cm H2O, cardiac performance was impaired significantly, with a profound decrease of the systemic and pulmonary blood flow, SVRV and SVLV and a reflectory increase of the Rs. Surprisingly, the heart rate and mean arterial BP remained constant. The effective left ventricular afterload, which takes into account the changing intrathoracic pressure, increased slightly with increasing PEEP.
由于测定早产儿的心输出量很困难，对于这一年龄组患者呼气末正压通气（PEEP）的血流动力学效应了解甚少。我们使用脉冲波多普勒超声心动图评估了10例患有呼吸窘迫综合征的早产儿增加PEEP时的血流动力学效应。在PEEP为4 cm H₂O时，体循环和肺循环血流量以及右心室（SVRV）和左心室（SVLV）每搏输出量略有下降，而体循环血管阻力（Rs）略有增加。在PEEP为8 cm H₂O时，心脏功能显著受损，体循环和肺循环血流量、SVRV和SVLV显著下降，Rs反射性增加。令人惊讶的是，心率和平均动脉血压保持不变。考虑到胸内压变化的有效左心室后负荷随着PEEP的增加略有增加。
