摘要
目的 探讨控制性肺膨胀 (SI)同小潮气量通气模式结合对急性肺损伤 (ALI)患者的肺复张作用及其对血流动力学的影响。方法 选择严重创伤并发ALI的患者 ,先予基础通气 1h ,然后分别给予 2 0cmH2 O× 3 0s(SI1 )、3 0cmH2 O× 3 0s(SI2 )、40cmH2 O× 3 0s(SI3)、5 0cmH2 O× 3 0s(SI4 )的SI各通气 1h ,在基础通气 1h、SI后 1h以及回到基础通气 1h各时点监测肺机械力学和血流动力学指标。结果 与基础通气模式相比 ,SI1 及SI2 后各指标无明显变化 ,SI3和SI4 后EE LV显著增加 ,Cst显著提高 ,而Paw、PAP和PVRI则显著降低 ,SI对HR、AP、CI等血流动力学指标均无显著影响。结论 SI同小潮气量通气模式结合治疗ALI患者时 ,具有肺复张作用 ,能改善肺顺应性 。
Objective To investigate the effects of sustained inflation (SI) combined with small tidal volume ventilation on lung recruitment and hemodynamics in patients with acute lung injury (ALI). Methods Patients with severe trauma followed by ALI were selected for this study. Patients underwent small tidal volume ventilation (baseline) for 1 h and then SI with 20 cm H 2O×30 s(SI 1), 30 cm H 2O×30 s(SI 2), 40 cm H 2O×30 s(SI 3) and 50 cm H 2O×30 s(SI 4) for 1 h, respectively. Parameters of pulmonary mechanics and hemodynamics were measured at 1 h after baseline, SI and returning baseline, respectively. Results Compared with those of the baseline, no changes of parameters were found after SI 1 and SI 2, but EELV and Cst increased significantly after SI 3 and SI 4. Paw, PAP and PVRI decreased significantly after SI 3 and SI 4. After SI interruption, all the physiological variables returned to baseline. SI had no significant effect on HR, AP and CI. Conclusion Treatment with SI combined with small tidal volume ventilation in patients with ALI can provide lung recruitment and improve lung compliance, but it has no significant side effect on hemodynamics.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2003年第18期1662-1664,共3页
Journal of Third Military Medical University
关键词
控制性肺膨胀
小潮气量通气
急性肺损伤
肺复张
sustained inflation
small tidal volume ventilation
acute lung injury
lung recruitment
