Bullemer F, Faderl B, Karg O
Pneumologische Klinik, Zentralkrankenhaus Gauting.
Med Klin (Munich). 1995 Apr;90(1 Suppl 1):7-8.
In patients with ventilatory pump disorder cardiac decompensation can occur after introduction of nasal intermittent positive pressure ventilation therapy (nasal IPPV). Therefore we carried out hemodynamic measurements in eight patients.
Before starting non-invasive ventilation and 1 hour later we measured pulmonary artery pressures, central venous pressures, pulmonary capillary wedge pressures and cardiac output. Blood gas analysis of arterial and mixed venous blood were carried out. We calculated oxygen delivery and oxygen extraction rate.
After 1 hour of ventilation cardiac output was reduced from 5.9 l/min to 4.1 l/min, oxygen delivery was reduced from 1002 ml/min to 771 ml/min. These results were significant. Three patients were measured hourly during a prolonged period of ventilation. After 4 to 6 hours cardiac output almost reached again the level before ventilation.
Similar to invasive ventilation or nCPAP-therapy non-invasive ventilation (nIPPV) causes a significant reduction of cardiac output 1 hour after starting ventilation. An adaptation of cardiac output could be reached after a couple of hours.
在通气泵功能障碍患者中，引入经鼻间歇正压通气治疗（经鼻IPPV）后可能会发生心脏代偿失调。因此，我们对8例患者进行了血流动力学测量。
在开始无创通气前及1小时后，我们测量了肺动脉压、中心静脉压、肺毛细血管楔压和心输出量。对动脉血和混合静脉血进行了血气分析。我们计算了氧输送量和氧摄取率。
通气1小时后，心输出量从5.9升/分钟降至4.1升/分钟，氧输送量从1002毫升/分钟降至771毫升/分钟。这些结果具有显著性。在长时间通气期间，对3例患者进行了每小时一次的测量。4至6小时后，心输出量几乎再次达到通气前的水平。
与有创通气或nCPAP治疗类似，无创通气（nIPPV）在开始通气1小时后会导致心输出量显著降低。数小时后心输出量可出现适应性变化。
