摘要
目的探讨吸入氧浓度(FiO2)和呼气末气道正压(PEEP)对氧合指数(OI)以及急性肺损伤(ALI)、急性呼吸窘迫综合征(ARDS)诊断的影响。方法监测FiO2=100%、PEEP=0时满足ARDS诊断标准模型犬(10只)和患者(10例)在不同FiO2(PEEP=0,FiO2=100%、FiO2=60%、FiO2=21%或FiO2=30%)和PEEP水平(FiO2=100%,PEEP=0·5cmH2O、PEEP=10cmH2O)时OI的变化。结果OI随着FiO2的降低或PEEP的增高而增大,其中FiO2由60%降至21%(患者为30%)或PEEP由5cmH2O升至10cmH2O时OI的变化最显著(P<0·05);同时随着OI的增大,满足ARDS诊断标准的例数逐渐减少,而符合ALI诊断标准的例数增多,甚至出现OI>300mmHg不再符合ARDS或ALI诊断的现象。结论FiO2和PEEP对OI影响显著,从而直接影响ALI、ARDS的诊断结果。因此ALI、ARDS诊断时应严格限定FiO2和PEEP。
Objective To study the effects of the fraction of inspired oxygen （FiO2 ） and positive end expiratory pressure （PEEP） on oxygen index （OI） and the diagnosis of acute lung injury （ALl） and acute respiratory distress syndrome （ARDS）. Methods OI of 10 dogs and 10 patients were recorded when FiO2 was 100% , 60% , 21% （PEEP = 0） or PEEP was 0, 5, 10 cmH2O （FiO2 = 100% ）, respectively. The dogs and patients met the criteria of ARDS with 100% FiO2 and 0 PEEP. Results OI increased with the decrease of FiO2 or the elevation of PEEP, especially when FiO2 dropped from 60% to 21% （or patients to 30%） or PEEP elevated from 5 to 10 cmH20 （P 〈 0.05）. The number of ARDS patients who met the criteria reduced and the number of ALl increased with the increase of OI, and even some patients couldn＇t be diagnosed as ALl or ARDS any more when FiO2 was 21% （30% in patients） or PEEP was 10 cmH20 because OI was more than 300 mmHg. Conclusion FiO2 and PEEP affected OI remarkably, so they influenced the diagnosis of ALl and ARDS accordingly. Fi02 and PEEP should be restricted when OI was used. to diagnose ALl and ARDS.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第11期971-974,共4页
Chinese Journal of Emergency Medicine
关键词
氧合指数
吸入氧浓度
呼气末气道正压
急性肺损伤
急性呼吸窘迫综合征
Oxygen index
Fraction of inspired oxygen
Positive end expiratory pressure
Acute lung injury
Acute respiratory distress syndrome
