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呼气末正压对13例非血流动力学肺水肿患者的即刻及中期心肺效应

Immediate and middle-term cardiorespiratory effects of positive end-expiratory pressure in thirteen cases of non-haemodynamic pulmonary oedema.

作者信息

Jardin F, Gurdjian F, Eveleight M C, Fouilladieu J L, Margairaz A

出版信息

Resuscitation. 1978;6(2):125-9. doi: 10.1016/0300-9572(78)90019-9.

Abstract

Thirteen patients with severe acute respiratory failure were ventilated with positive end-expiratory pressure (PEEP) for 9 days. Haemodynamic measurements were performed after 15 min during 100% oxygen breathing, first with intermittent-positive pressure ventilation, secondly with positive end-expiratory pressure. The latter improved the Pa, O2 from 89 to 150 torr, decreased the QS/QT from 43% to 32% and decreased the Pa, CO2 from 37 to 34 torr; this improvement in gas exchange was accompanied by a decrease in cardiac index from 4.4 to 3.7 1 min-1m-2 without changing the systemic arterial pressure. Despite this beneficial effect on arterial blood oxygenation, it did not improve the survival rate of patients with severe acute respiratory failure.

摘要

13例严重急性呼吸衰竭患者接受呼气末正压(PEEP)通气9天。在100%氧气呼吸期间,于15分钟后进行血流动力学测量,首先采用间歇正压通气,其次采用呼气末正压通气。后者使动脉血氧分压(Pa,O₂)从89托升至150托,使分流率(QS/QT)从43%降至32%,并使动脉血二氧化碳分压(Pa,CO₂)从37托降至34托;气体交换的这种改善伴随着心脏指数从4.4降至3.7升/分钟·平方米,而全身动脉压未改变。尽管对动脉血氧合有这种有益作用,但它并未提高严重急性呼吸衰竭患者的生存率。

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