两种通气方法对健康及急性肺损伤犬心肺功能影响的比较研究

目的比较双水平压力调节（ＢｉＰＡＰ）通气和间歇正压通气（ＩＰＰＶ）对心肺功能的影响。方法在两种通气模式０、０．５、１ｋＰａ呼气末压（ＥＥＰ）时分别测定健康犬及油酸诱发急性肺损伤犬的呼吸力学、血流动力学及血气分析各参数。结果无论有无急性肺损伤，ＢｉＰＡＰ通气在ＥＥＰ为０、０．５、１ｋＰａ时的气道平均压均低于ＩＰＰＶ时，但心输出量等血流动力学参数并无明显差异。另外在急性肺损伤时，ＢｉＰＡＰ通气时血氧分压（ＰａＯ２、ＰｖＯ２）均较ＩＰＰＶ时增高。结论与ＩＰＰＶ相比，ＢｉＰＡＰ通气能显著降低气道压力，在急性肺损伤时，可有效改善动脉血氧分压，但对血流动力学的影响两者无明显差异。

Cardiopulmonary effects of two modes of mechanical ventilation in dogs with and without acute lung in jury comparison of pressure regulated biphasic airway presure ventilation and intermittent positive pressure ventilation

Objective To compare the cardiopulmonary effect of pressure regulated biphasic airway pressure (BiPAP) and intermittent positive pressure ventilation (IPPV). Methods Airway pressure, hemodynamics and blood gases were measured during the two ventilatory modalities with 0, 0.5, 1 kPa external end expiratory pressure (EEP) in dogs with and without oleic acid induced lung injury. ResultsNo matter whether there is lung injury, airway pressure during BiPAP is lower compared with IPPV, but there is no difference in cardiac output. In dogs with lung injury , PaO 2 during BiPAP is higher than that during IPPV. Conclusions Compared with IPPV, BiPAP effected a decrease in airway pressure, and PaO 2 was improved in dogs with lung injury, although the cardiac output was not increased.