Simonneau G, Lemaire F, Harf A, Safran D, Georges C, Rieuf P, Teisseire B, Rapin M
Nouv Presse Med. 1979 Jan 13;8(2):113-5.
The hemodynamic and respiratory effects of spontaneous ventilation with continuous positive airway pressure (CPAP) and mechanical ventilation with positive and expiratory pressure (CPPV) were compared in six patients with acute respiratory failure. Arterial and mixed venous gases, cardiac output, oxygen delivery and consumption, airway and oesophageal pressures were measured, with each patient on intermittent positive pressure ventilation (IPPV), CPAP and CPPV with the same level of positive and expiratory pressure (PEEP = 20 cmH2O). CPAP was as efficient as CPPV for improving arterial oxygenation. Cardiac output was higher on CPAP than on CPPV due to a lower intra-thoracic pressure with spontaneous ventilation, thus oxygene transport was higher with this methode. However total oxygene consumption and PaCO2 were slightly increased with CPAP due to a higher breathing's work. So, CPAP is as efficient as CPPV at the same level of PEEP in improving intra-pulmonary shunt and PaO2, without adversely affecting cardiac output.
对6例急性呼吸衰竭患者比较了持续气道正压通气（CPAP）自主呼吸和呼气末正压通气（CPPV）机械通气的血流动力学和呼吸效应。测量了动脉血和混合静脉血气体、心输出量、氧输送和消耗、气道和食管压力，每名患者均接受间歇正压通气（IPPV）、CPAP和具有相同水平呼气末正压（PEEP = 20 cmH₂O）的CPPV。CPAP在改善动脉氧合方面与CPPV同样有效。由于自主呼吸时胸内压较低，CPAP时的心输出量高于CPPV，因此该方法的氧输送较高。然而，由于呼吸功增加，CPAP时总氧消耗和PaCO₂略有增加。所以，在相同PEEP水平下，CPAP在改善肺内分流和PaO₂方面与CPPV同样有效，且不会对心输出量产生不利影响。
