无创正压通气对脓毒症所致急性肺损伤患者血流动力学的影响

目的研究无创正压通气(noninvasive positive ventilation,NIPPV)对脓毒症所致急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)早期患者血流动力学的影响。方法收集脓毒症所致ALI/ARDS共27例,观察通气前,通气后2～4 h、24 h及撤机后的动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、心率(HR),以及无创心功能所测平均动脉压(MAP)、心脏指数(CI)、心排血量(CO)、体循环血管阻力(SVR)等指数变化。结果经NIPPV治疗后,患者PaO2、SaO2较通气前显著增高(P<0.01),HR下降(P<0.05),MAP、CI、CO、SVR较通气前无显著改变(P>0.05)。结论 NIPPV能提高脓毒症所致ALI/ARDS早期患者的SaO2、PaO2,同时对血流动力学没有不良影响。

Effects of noninvasive positive ventilation on hemodynamics in patients with acute lung injury induced by sepsis

Objective To investigate the effects of noninvasive positive ventilation（NIPPV） on hemodynamics of patients with acute lung injury/acute respiratory distress（ALI/ARDS） induced by sepsis.Methods Twenty nine patients with ALI/ARDS induced by sepsis were included in the study.The blood gas analysis（SaO2,PaO2 and PaCO2）,HR,and hemodynamics（MAP,CI,CO,SVR） measured by noninvasive heart function before and 2-4 hours,24 hours after NIPPV,and withdrawing of NIPPV were recorded and analyzed.Results The index（PaO2,SaO2） were increased（P0.01）,HR was improved（P0.05）after treatment of NIPPV;while there were no significant differences in hemodynamics（MAP,CI,CO,SVR） before and after treatment（P0.05）.Conclusion For patients with ALI/ARDS induced by sepsis in the early stage,NIPPV treatment can improve the arterial oxygen saturation（SaO2） and arterial partial pressure of oxygen（PaO2）,and has no significant side effects on circulation dynamics.