Schmidt G B, O'Neill W W, Kotb K, Hwang K K, Bennett E J, Bombeck C T
Surg Gynecol Obstet. 1976 Oct;143(4):613-8.
After an operation upon the abdomen, certain patients have a high risk of developing acute respiratory failure or the adult respiratory distress syndrome. These patients at high risk have been mechanically ventilated during the postoperative period in an attempt to prevent the onset of respiratory insufficiency. As a method of prophylaxis, continuous positive airway pressure has the advantages of increasing the functional residual capacity with minimal effects on the cardiac output, low potential for barotrauma and simplicity of equipment. Alternate patients at risk following an operation on the upper part of the abdomen were placed on 8 centimeters of water continuous positive airway pressure for the first 24 hours postoperatively. Fifty-six controls and 56 patients receiving continuous positive airway pressure were studied. In ten controls, adult respiratory distress syndrome developed, and three died in respiratory failure. Only one of the group receiving continuous positive airway pressure met standard criteria for the diagnosis of adult respiratory distress syndrome. In addition, in 25 patients serving as controls, respiratory complications other than adult respiratory distress syndrome developed compared with the development in only 11 receiving continuous positive airway pressure9
腹部手术后，部分患者发生急性呼吸衰竭或成人呼吸窘迫综合征的风险较高。这些高危患者在术后期间接受机械通气，试图预防呼吸功能不全的发生。作为一种预防方法，持续气道正压通气具有增加功能残气量、对心输出量影响最小、气压伤可能性低以及设备简单等优点。对腹部上半部分手术后的高危患者，术后头24小时给予8厘米水柱的持续气道正压通气。研究了56例对照患者和56例接受持续气道正压通气的患者。10例对照患者发生成人呼吸窘迫综合征，3例死于呼吸衰竭。接受持续气道正压通气的患者中只有1例符合成人呼吸窘迫综合征的诊断标准。此外，25例对照患者发生了除成人呼吸窘迫综合征之外的呼吸并发症，而接受持续气道正压通气的患者中只有11例发生此类并发症。
