[间歇性自主通气对通气驱动和呼吸泵功能的影响]
[Effects of intermittent self-ventilation on ventilatory drive and respiratory pump function].
作者信息
Schucher B, Laier-Groeneveld G, Hüttemann U, Criée C P
机构信息
Kreiskrankenhaus an der Lieth, Bovenden-Lenglern.
出版信息
Med Klin (Munich). 1995 Apr;90(1 Suppl 1):13-6.
BACKGROUND
A chronic hypercapnic ventilatory failure appears in patients with restrictive chest wall disorders, chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea (OSA), but it can also appear in patients with a disorder of the central respiratory drive.
PATIENTS AND METHOD
We studied the lung function, the respiratory muscle function and the PCO2 recruitment threshold (pCO2RT) during nasal intermittent positive pressure ventilation (IPPV) in 16 chronic hypercapnic patients (scoliosis = 8, COPD = 4, OSA = 4).
RESULTS
The pCO2RT decreased from 61 +/- 6 mm Hg to 48 +/- 4 mm Hg (p < 0.0001) during intermittent IPPV, while spontaneous pCO2 decreased from 55 +/- 6 mm Hg to 42 +/- 5 mm Hg (p < 0.0001). The load of the respiratory pump decreased (P0.1/P0.1 max:0.27 +/- 0.18 before, 0.15 +/- 0.08 after intermittent IPPV; p < 0.04).
CONCLUSION
We conclude, that the pCO2RT can be normalized by intermittent nasal IPPV as well as the pCO2 under spontaneous breathing. The load of the respiratory pump decreases due to an increase of the inspiratory muscle strength.
背景
慢性高碳酸血症性通气衰竭见于胸廓限制性疾病、慢性阻塞性肺疾病（COPD）或阻塞性睡眠呼吸暂停（OSA）患者，但也可出现在中枢呼吸驱动障碍患者中。
患者与方法
我们研究了16例慢性高碳酸血症患者（脊柱侧弯8例、COPD 4例、OSA 4例）在经鼻间歇正压通气（IPPV）期间的肺功能、呼吸肌功能及PCO₂募集阈值（pCO₂RT）。
结果
在间歇IPPV期间，pCO₂RT从61±6mmHg降至48±4mmHg（p<0.0001），而自主呼吸时的pCO₂从55±6mmHg降至42±5mmHg（p<0.0001）。呼吸泵负荷降低（P0.1/P0.1max：间歇IPPV前为0.27±0.18，之后为0.15±0.08；p<0.04）。
结论
我们得出结论，经鼻间歇IPPV可使pCO₂RT正常化，自主呼吸时的pCO₂也可正常化。由于吸气肌力量增加，呼吸泵负荷降低。
Zotero 插件