呼气末正压通气对闭胸猪心脏功能的影响。
The effect of peep-ventilation on cardiac function in closed chest pigs.
作者信息
Berglund J E, Haldén E, Jakobson S
机构信息
Department of Anaesthesiology and Intensive Care, University Hospital, Uppsala, Sweden.
出版信息
Ups J Med Sci. 1994;99(2):167-78. doi: 10.3109/03009739409179361.
OBJECTIVE
Does ventilation with positive end-expiratory pressure (PEEP) depress myocardial contractility?
DESIGN
Ten piglets were anaesthetized and prepared for the measurement of cardiac output (SV) and right (MRAPtm) and left (MLAPtm) mean transmural atrial pressure, the latter serving as indices of preload. 500 ml of autologous blood was re-transfused during intermittent positive pressure ventilation without PEEP (IPPV) and continuous positive pressure ventilation with 15 cm H2O PEEP (CPPV).
MEASUREMENTS AND RESULTS
Right and left ventricular function curves were drawn by plotting MRAPtm and MLAPtm respectively versus the corresponding strokevolumes before and after re-transfusion. Similar inclinations were obtained during IPPV and CPPV on either side of the heart.
CONCLUSIONS
Although the ventricular function curves during IPPV and CPPV covered partially different preload levels, the results suggest that CPPV i.e. PEEP does not affect myocardial contractility.
目的
呼气末正压通气（PEEP）是否会降低心肌收缩力？
设计
对十只仔猪进行麻醉，并准备测量心输出量（SV）以及右心房平均跨壁压（MRAPtm）和左心房平均跨壁压（MLAPtm），后者作为前负荷指标。在无PEEP的间歇正压通气（IPPV）和15 cm H2O PEEP的持续正压通气（CPPV）期间，回输500 ml自体血。
测量与结果
通过分别绘制回输前后MRAPtm和MLAPtm与相应每搏量的关系曲线，得到左右心室功能曲线。在心脏两侧的IPPV和CPPV期间获得了相似的斜率。
结论
尽管IPPV和CPPV期间的心室功能曲线部分覆盖了不同的前负荷水平，但结果表明CPPV即PEEP不影响心肌收缩力。
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