Takeda S, Nakanishi K, Takano T, Nejima J, Takayama M, Sakamoto A, Ogawa R
Division of Intensive Care, Nippon Medical School, Tokyo, Japan.
Nihon Ika Daigaku Zasshi. 1997 Oct;64(5):440-5. doi: 10.1272/jnms1923.64.440.
The purpose of this study was to evaluate the efficacy of external high-frequency oscillation (EHFO) in patients with hypercapnia following upper abdominal surgery. Seven patients were ventilated with EHFO for 2 hr at 60 oscillations/min, with cuirass pressures of 36 cm H2O (-26 to +10), and an inspiratory to expiratory ratio of 1:1. Blood gases and cardiac functional parameters were examined during the 2 hr on EHFO. Pulmonary functional parameters were analyzed prior to the institution and after the termination of EHFO. PaCO2 significantly decreased from 61 +/- 8 mmHg to 48 +/- 7 mmHg after 10 min on EHFO (p < 0.01). PaO2 significantly increased from 74 +/- 10 mmHg 95 +/- 26 mmHg after 1 hr on EHFO (p < 0.01). The heart rate decreased significantly from 108 +/- 27 beats/min to 101 +/- 24 beats/min after 30 min on EHFO (p < 0.05). The FEV1 and FVC significantly increased from 1.09 +/- 0.54 L to 1.50 +/- 0.46 L (p < 0.01) and from 1.90 +/- 0.74 L to 2.18 +/- 0.60 L (p < 0.05), respectively. The other parameters of lung function also significantly improved after the termination of EHFO. The significant changes in all of the pulmonary functional parameters continued for 1 hr after the termination of EHFO. EHFO is an effective method of gas exchange which is associated with earlier return to preoperative lung function.
本研究的目的是评估体外高频振荡（EHFO）对上腹部手术后高碳酸血症患者的疗效。7例患者以60次/分钟的频率接受EHFO通气2小时，胸甲压力为36 cm H2O（-26至+10），吸呼比为1:1。在接受EHFO通气的2小时内检查血气和心功能参数。在开始和结束EHFO之前分析肺功能参数。EHFO通气10分钟后，PaCO2从61±8 mmHg显著降至48±7 mmHg（p<0.01）。EHFO通气1小时后，PaO2从74±10 mmHg显著升至95±26 mmHg（p<0.01）。EHFO通气30分钟后，心率从108±27次/分钟显著降至101±24次/分钟（p<0.05）。FEV1和FVC分别从1.09±0.54 L显著增加至1.50±0.46 L（p<0.01）和从1.90±0.74 L显著增加至2.18±0.60 L（p<0.05）。EHFO结束后，其他肺功能参数也显著改善。所有肺功能参数的显著变化在EHFO结束后持续1小时。EHFO是一种有效的气体交换方法，与更早恢复术前肺功能相关。
