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| PEEP对急性呼吸衰竭病人全身氧供给的影响 | |
| 引用本文： | 单红卫,杨兴易,陈学云,景炳文. PEEP对急性呼吸衰竭病人全身氧供给的影响[J]. 中国急救医学, 1999, 19(4): 207-208 |
| 作者姓名： | 单红卫 杨兴易 陈学云 景炳文 |
| 作者单位： | 第二军医大学附属长征医院急救科,上海,200003 |
| 摘 要： | 目的探讨呼气末正压（ＰＥＥＰ）通气对急性呼吸衰竭病人全身氧供给（ＤＯ２）的影响。方法选择２０例急性呼吸衰竭机械通气病人，放置Ｓｗａｎ－Ｇａｎｚ导管，依次调节ＰＥＥＰ为０、０４９ｋＰａ、０９８ｋＰａ、１４７ｋＰａ四种压力水平，分别测定气体交换功能及氧动力学指标。结果ＰＥＥＰ为０４８ｋＰａ时动脉血氧分压（ＰａＯ２）即开始明显升高（Ｐ＜０５），心脏指数（ＣＩ）却出现降低（Ｐ＜００５），随着ＰＥＥＰ增加，ＣＩ逐渐下降。ＤＯ２在ＰＥＥＰ为０９８ｋＰａ以下时变化不显著，在１４７ｋＰａ时出现显著下降（Ｐ＜００５），而氧摄取率（ＥｘｔＯ２）则有所增加（Ｐ＜００５）。结论ＰＥＥＰ使用不能明显提高ＤＯ２，高水平的ＰＥＥＰ可以降低ＤＯ２，必须采取措施提高ＣＩ才能使ＤＯ２增加。 |
| 关 键 词： | 呼气末正压通气 氧供给 心脏指数 呼吸衰竭 |
Effects of PEEP on systemic oxygen delivery in patients with acute respiratory failure |
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| Shan Hongewei,Yang Xingyi,Chen Xueyun,et al.. Effects of PEEP on systemic oxygen delivery in patients with acute respiratory failure[J]. Chinese Journal of Critical Care Medicine, 1999, 19(4): 207-208 | |
| Authors: | Shan Hongewei Yang Xingyi Chen Xueyun et al. |
| Affiliation: | Shan Hongewei,Yang Xingyi,Chen Xueyun,et al.Department of Critical Care Medicine,Changzheng Hospital,Second Military Medical University,Shanghai 200003 |
| Abstract: | Objective To observe the effects of external positive end-expiratory pressure (PEEP)on systemic oxygen delivery (DO 2) in patients with acute respratory failure (ARF) Methods We studied twenty ARF patients with mechanical ventilation.Swan-Ganz catheter was inserted into pulmonary artery.Increment levels of PEEP(0,0 49 kPa,0 98 kPa,1 47kPa) were applied sequentially.The parameters of blood gas exchange and oxygen kinetics were measured,respectively.Results Arterial oxygen tension(PaO 2) increased significantly( P <0 05) at PEEP 0 49 kPa,associated with reduction (P <0 05) in cardiac index (CI).With the increase in PEEP levels,CI decreased progressively.DO 2 was unchanged when PEEP was below 0 98 kPa.At PEEP 1 47 kPa,DO 2 began to reduce ( P <0 05) and oxygen extraction rate (ExtO 2) was elevated ( P <0 05) compensatively.Conclusion DO 2 is not able to be increased with application of PEEP.Reduction in DO 2 may be caused by high levels of PEEP.Further management should be taken to elevate CI as well as DO 2. [ |
| Keywords: | Positive-pressure respiration Oxygen delivery Cardiac index Respiratory failure |
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