Duma S, Baum M, Benzer H, Koller W, Mutz N, Pauser G
Anaesthesist. 1982 Oct;31(10):549-56.
Based on our positive experiences with "Inversed Ratio Ventilation" (IRV) in the treatment of ARDS, we applied this ventilation technique in patients with risk lungs after cardiosurgical operations. Immediately, after switching from conventional ventilation mode (I/E ratio 1:2) to IRV (I/E 2:1), however significant hemodynamic reactions could be observed. Especially a significant decrease of cardiac output can be observed in this phase. IRV leads to an improvement of gas exchange and lung mechanics. These improvement become even more significant continuing IRV. A decreasing tendency of the negative hemodynamic effects can be observed parallel to lung mechanics improvement. Carefully managed respirators adjustment, "step-wise" prolongation of I/E ratio and closed observation on hemodynamic reactions leads to successful use of Inversed Ratio Ventilation in cardiosurgical patients too.
基于我们在治疗急性呼吸窘迫综合征（ARDS）时使用“反比通气”（IRV）的积极经验，我们将这种通气技术应用于心脏外科手术后具有肺部风险的患者。然而，在从传统通气模式（吸呼比1:2）切换到IRV（吸呼比2:1）后，立即观察到了明显的血流动力学反应。特别是在这个阶段可以观察到心输出量显著下降。IRV可改善气体交换和肺力学。持续进行IRV时，这些改善会变得更加显著。随着肺力学的改善，可以观察到负面血流动力学效应有下降趋势。精心管理呼吸机调整、“逐步”延长吸呼比并密切观察血流动力学反应，也能使反比通气在心脏外科手术患者中成功应用。
