Dick W, Lotz P, Milewski P, Schindewolf H
Resuscitation. 1979;7(3-4):255-62. doi: 10.1016/0300-9572(79)90033-9.
After positive end-expiratory pressure (PEEP) valves for manually operated resuscitators became available it was of interest to find out whether PEEP should be applied at the scene of accident in nearly drowned patients. In 27 young pigs 25 ml of fresh water/kg body weight was instilled into the lungs via an endotracheal tube. After a period of apnoea (4 min) the pigs were ventilated artificially with 100% oxygen with either 5 cm PEEP or zero end-expiratory pressure (ZEEP). Within the PEEP group the AaDO2 returned to normal within the first 10 min after resuscitation, whereas the AaDO2 did not reach normal values for 2 h in the ZEEP group. The same observations were true for the PO2 values. Although the cardiac output decreased by almost 30% in the PEEP group, mean arterial pressures and heart rates remained unchanged. Lung weights and blood lactate concentrations confirmed that the same degree of water absorption and hypoxia had taken place in both groups. The conclusions from these experiments are that the application of 5 cm PEEP is part of the immediate measures of emergency treatment in nearly drowned victims.
在手动复苏器的呼气末正压（PEEP）阀问世后，人们开始关注在近乎溺水患者的事故现场是否应使用PEEP。给27只幼猪经气管内导管向肺内注入25毫升/千克体重的淡水。在出现呼吸暂停一段时间（4分钟）后，用100%氧气对猪进行人工通气，一组使用5厘米水柱的PEEP，另一组使用呼气末零压力（ZEEP）。在PEEP组中，复苏后最初10分钟内肺泡-动脉血氧分压差（AaDO2）恢复正常，而在ZEEP组中，AaDO2在2小时内未达到正常水平。动脉血氧分压（PO2）值也有同样的观察结果。虽然PEEP组的心输出量下降了近30%，但平均动脉压和心率保持不变。肺重量和血乳酸浓度证实两组发生了相同程度的水吸收和缺氧。这些实验得出的结论是，应用5厘米水柱的PEEP是近乎溺水受害者紧急治疗即刻措施的一部分。
