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持续正压通气和高频喷射通气加呼气末正压对正常犬的血流动力学影响。

Hemodynamic effects of continuous positive-pressure ventilation and high-frequency jet ventilation with positive end-expiratory pressure in normal dogs.

作者信息

Chiaranda M, Rubini A, Fiore G, Giron G, Carlon G C

出版信息

Crit Care Med. 1984 Sep;12(9):750-4. doi: 10.1097/00003246-198409000-00014.

Abstract

The hemodynamic effects of high-frequency jet ventilation (HFJV) at 60, 120, 240, and 480 breath/min, and conventional ventilation at 15 breath/min were compared in 6 anesthetized, paralyzed dogs, at 0, 10, and 20 cm H2O of positive end-expiratory pressure (PEEP). On HFJV at the same inspired oxygen, PaCO2, and PEEP levels, hemodynamic function improved significantly. Cardiac output was higher, whereas transmural CVP and pulmonary vascular resistances were lower. The improvement was primarily related to a decrease in mean airway pressure, particularly at higher PEEP levels. When PEEP was applied, hemodynamic function improved even when mean airway pressure was maintained constant. The findings suggest that lung volume was smaller during HFJV, and/or that lung volume changes during each respiratory cycle contributed to differences in venous return and ventricular function.

摘要

在6只麻醉、麻痹的犬中,于呼气末正压(PEEP)分别为0、10和20 cmH₂O时,比较了呼吸频率为60、120、240和480次/分钟的高频喷射通气(HFJV)以及呼吸频率为15次/分钟的传统通气的血流动力学效应。在相同的吸入氧浓度、动脉血二氧化碳分压(PaCO₂)和PEEP水平下进行HFJV时,血流动力学功能显著改善。心输出量更高,而跨壁中心静脉压(CVP)和肺血管阻力更低。这种改善主要与平均气道压降低有关,尤其是在较高的PEEP水平时。当应用PEEP时,即使平均气道压保持恒定,血流动力学功能也会改善。这些发现表明,HFJV期间肺容积较小,和/或每个呼吸周期中的肺容积变化导致了静脉回流和心室功能的差异。

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