机械辅助通气对心源性休克血流动力学的影响

目的:探讨机械通气对左心功能衰竭引起心源性休克的血流动力学变化的机制和疗效。方法:对39例左心衰致心源性休克病例随机分成机械通气组20例和对照组19例;机械通气组在药物治疗的基础上给予气管插管、呼吸机辅助通气,观察生命体征、血气分析以及血管活性物质在治疗前后的用量。结果:机械通气治疗2h后,血压开始显著回升,多巴胺输注速度减慢,血气分析pH、PaO2、PCO2均可维持在正常参考值范围,氧合指数显著上升。一周后机械通气组死亡2例,对照组死亡11例,P<0.05。结论:心源性休克行机械通气治疗可提高肺泡的氧合能力,有利于恢复患者血流动力学。

Hemodynamic Effect of Mechanical Ventilation for the Treatment of Cardiac Shock

Objective: To explore mechanism and clinical efficacy of mechanical ventilation in hemodynam with cardiac shock. Methods: 39 patients with cardiac shock caused by left heart failure were randomly assigned in receive either mechanical ventilation through intubation (ventilation group, 20 cases), conventional medical therapy (control group, 19 cases). Vital signs were continuously monitored, blood gas and vasoactive drugs were measured. Results: After 2h with mechanical ventilation, compared with the control group, there was a significant increase in arterial pressure and a drop in infusion rate of Dopamine. It is to maintain in the normal scope in blood pH, PaO2, PCO2, while a significant increase in PO2/FiO2. After 1 week, the ventilation group was improved according to died cases (2 vs 11,P < 0.05). Conclusions: Mechanical ventilation can enhance PaO2/FiO2 and stabilized hemodynam for cardiac shock caused by left heart failure.