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[心脏手术患者术后人工呼吸撤离,持续气道正压通气与零压呼气末正压通气的比较]

[Weaning postoperative artificial respiration in cardiac surgery patients, CPAP versus ZEEP].

作者信息

Koller W, Spiss C, Fina U, Duma S

出版信息

Anaesthesist. 1983 Oct;32(10):483-7.

PMID:6359947
Abstract

Pulmonary lesions following extracorporeal circulation (ECC) are said to be responsible for decreased functional residual capacity (FRC). Weaning from controlled mechanical ventilation (CMV) in the postoperative period is commonly performed by a CPAP system in order to restore the impaired oxygen exchange. Testing the superiority of CPAP against insufflation at atmospheric pressure (ZEEP), 33 patients after coronary bypass grafting (CABG) underwent from the end of CMV till extubation either CPAP or ZEEP in a randomized distribution. Data sampling included respiratory rate, paO2, paCO2 and AaDO2-Quotient (gas exchange), as well as HR, MAP, CVP and LAP (hemodynamics). None of the obtained data showed statistical significant differences between the CPAP and the ZEEP group. Therefore there appears to be no necessity for CPAP when weaning CABG patients, due to the absence of previous lung damage and the short time range of intubation and CMV.

摘要

体外循环(ECC)后的肺部病变被认为是功能残气量(FRC)降低的原因。术后从控制性机械通气(CMV)撤机通常通过持续气道正压通气(CPAP)系统进行,以恢复受损的氧交换。为了测试CPAP相对于常压吹入(ZEEP)的优越性,33例冠状动脉旁路移植术(CABG)患者在CMV结束至拔管期间以随机分配的方式接受了CPAP或ZEEP治疗。数据采样包括呼吸频率、动脉血氧分压(paO2)、动脉血二氧化碳分压(paCO2)和肺泡-动脉氧分压差(AaDO2)-商(气体交换),以及心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)和左房压(LAP)(血流动力学)。所获得的数据在CPAP组和ZEEP组之间均未显示出统计学上的显著差异。因此,由于CABG患者既往无肺损伤且插管和CMV时间较短,在撤机时似乎没有必要使用CPAP。

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