Räsänen J, Nikki P
Ann Chir Gynaecol Suppl. 1982;196:43-7.
Respiratory failure in a patient with acute myocardial infarction requires immediate attention in an attempt to prevent extension of the myocardial injury. Therapy should be based on a thorough cardiorespiratory analysis and careful monitoring, because erroneous decisions may have serious consequences when the circulation is marginal. If the patient is connected to a ventilator, a low IMV rate is haemodynamically preferable to CMV. Moderate PEEP can and should be used to decrease venous admixture and to increase lung compliance when needed. Face mask CPAP may, in some cases, make endotracheal intubation unnecessary.
急性心肌梗死患者出现呼吸衰竭需要立即予以关注,以防止心肌损伤扩大。治疗应基于全面的心肺分析和仔细的监测,因为当循环处于临界状态时,错误的决策可能会产生严重后果。如果患者连接了呼吸机,从血流动力学角度来看,低IMV率比CMV更可取。必要时可使用并应使用适度的呼气末正压通气(PEEP)来减少静脉血掺杂并增加肺顺应性。在某些情况下,面罩持续气道正压通气(CPAP)可能使气管插管不必要。