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冠状动脉搭桥术后机械通气撤离相关的气体交换改变

Gas exchange alterations associated with weaning from mechanical ventilation following coronary artery bypass grafting.

作者信息

Dantzker D R, Cowenhaven W M, Willoughby W J, Kirsh M M, Bower J S

出版信息

Chest. 1982 Dec;82(6):674-7. doi: 10.1378/chest.82.6.674.

Abstract

This study was done to clarify the effects of positive-pressure mechanical ventilation on gas exchange in the lungs of conscious patients. Nine hemodynamically stable patients were studied following coronary artery bypass grafting at the time they were weaned from mechanical ventilation. The adequacy of gas exchange was assessed by traditional measurements as well as the multiple inert gas technique used to measure the ventilation-perfusion (VA/Q) distribution. During mechanical ventilation, gas exchange was characterized by a variable degree of VA/Q inequality as well as a substantial shunt ranging from 11.9 to 27.7 percent. Following removal from mechanical ventilation, there was a decrease in the mean VA/Q subsequent to a decrease in the minute ventilation. However, there was no significant change in the level of shunt or in the amount of VA/Q inequality.

摘要

本研究旨在阐明正压机械通气对清醒患者肺部气体交换的影响。对9例冠状动脉搭桥术后血流动力学稳定且正在撤离机械通气的患者进行了研究。通过传统测量方法以及用于测量通气-灌注(VA/Q)分布的多惰性气体技术评估气体交换的充分性。在机械通气期间,气体交换的特征是VA/Q不平等程度可变以及存在11.9%至27.7%的大量分流。撤离机械通气后,分钟通气量减少,随后平均VA/Q降低。然而,分流水平或VA/Q不平等程度没有显著变化。

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