体外二氧化碳清除的低频正压通气期间的血流动力学和肾功能。与持续正压通气的比较。

Hemodynamics and renal function during low frequency positive pressure ventilation with extracorporeal CO2 removal. A comparison with continuous positive pressure ventilation.

作者信息

Gattinoni L, Agostoni A, Damia G, Cantaluppi D, Bernasconi C, Tarenzi L, Pelizzola A, Rossi G P

出版信息

Intensive Care Med. 1980 May;6(3):155-61. doi: 10.1007/BF01757297.

Abstract

Six lambs were anesthetized and connected venovenous mode to a Membrane Lung for Extracorporeal CO2 removal. The animals underwent several hours periods of continuous positive pressure ventilation (CPPV), at 5 cmH2O positive end expiratory pressure (PEEP), alternated with several hours periods of low frequency positive pressure ventilation (5 cmH2O PEEP, 2 b.p.m.) with extracorporeal CO2 removal (LFPPV-ECCO2R). During LFPPV-ECCO2R compared with CPPV, cardiac output increased by 26%, pulmonary vascular resistances and systemic vascular resistances decreased by 28% and 22% respectively. The renal function improved significantly during LFPPV-ECCO2R compared with CPPV, i.e. urinary flow, creatinine clearance and osmolar clearance increased by 50%, 37% and 52% respectively. In these experiments LFPPV-ECCO2R, a form of completely artificial ventilation, seems to prevent hemodynamic and renal complications of CPPV.

摘要

六只羔羊被麻醉，并通过静脉-静脉模式连接到膜肺以进行体外二氧化碳清除。这些动物经历了数小时的持续正压通气（CPPV），呼气末正压（PEEP）为5 cmH2O，期间穿插数小时的低频正压通气（5 cmH2O PEEP，2次/分钟）并进行体外二氧化碳清除（LFPPV-ECCO2R）。与CPPV相比，在LFPPV-ECCO2R期间，心输出量增加了26%，肺血管阻力和体循环血管阻力分别降低了28%和22%。与CPPV相比，LFPPV-ECCO2R期间肾功能显著改善，即尿量、肌酐清除率和渗透清除率分别增加了50%、37%和52%。在这些实验中，LFPPV-ECCO2R这种完全人工通气的形式似乎可以预防CPPV的血流动力学和肾脏并发症。