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[压力支持通气方案在心脏手术后自主呼吸恢复中的应用]

[The use of a pressure-support ventilation regimen in the recovery of spontaneous respiration after heart operations].

作者信息

Nikitin E S, Tskhovrebov S V, Zatevakhina M V, Makrushin I M, Suvorova G Iu, Safonova E M

出版信息

Anesteziol Reanimatol. 1998 Jul-Aug(4):31-6.

PMID:9770816
Abstract

Pressure-support ventilation (PSV) with supporting pressure (SP) levels 20, 15, 13, 10, and 8 mm H2O was used in 111 patients with congenital heart disease after open-heart surgery during transfer to spontaneous respiration. PSV was associated with a significant decrease of respiratory rate and increase of respiratory volume (RV) at high SP levels. Respiration in the PSV mode permits the patient to control the inspiration flow, duration of inspiration phase, and RV, thus improving the patient-device synchronization. Cardiac index (CI) was changing with decrease of SP from 20-15 to 13 mm H2O in patients with different diseases during high SP PSV. This is caused by changed pulmonary circulation (transfer to intraacinar type) which increased the negative correlation between CI and chosen SP. In addition, CI depends not only on RV, but on the status of lung parenchyma as well.

摘要

在111例先天性心脏病患者心脏直视手术后转为自主呼吸的过程中,使用了支持压力(SP)水平分别为20、15、13、10和8 mmHg的压力支持通气(PSV)。在高SP水平时,PSV与呼吸频率显著降低和呼吸量(RV)增加有关。PSV模式下的呼吸使患者能够控制吸气流量、吸气相持续时间和RV,从而改善患者与设备的同步性。在高SP PSV期间,不同疾病患者的心脏指数(CI)随着SP从20降至15再降至13 mmHg而发生变化。这是由于肺循环改变(转变为腺泡内型)导致CI与所选SP之间的负相关性增加所致。此外,CI不仅取决于RV,还取决于肺实质的状态。

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