血液滤过对严重创伤后并发急性呼吸窘迫综合征患者氧合功能和血流动力学的影响

目的 研究血液滤过对严重创伤后并发ARDS患者氧合功能和血流动力学的影响。方法 选择严重创伤后ARDS患者12例，在呼吸机辅助或控制呼吸下行血液滤过治疗，于血液滤过后1－5d内用Swan-Ganz漂浮导管监测血流动力学和肺氧功能的变化。结果 与血液滤过前比较，滤过后第1天CVP、MPAP、SVRI、PVRI显著降低，整个血液滤过时间PaO2／FiO2升高非常显著，MAP、PCWP、HR、CI、DO2、VO2、ExtrO2、Qs/Qt无显著变化。结论 血液滤过对严重创伤后ARDS患者的血流动力学和氧合功能无明显影响，但可使氧合指数升高。

Effects of hemofiltration on hemodynamics and oxygenation in patients with ARDS after severe trauma

Objective To study the effects of hemofiltration on hemodynamics and oxygenation in patients with ARDS after severe trauma Methods 12 patients with ARDS after severe trauma were selected and treated with hemofiltration under respiratory support Hemodynamics and oxygenation were measured or calculated at scheduled intervals by use of Swan-Ganz catheters.Results Central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),indices of systemic vascular resistance and pulmonary vascular resistance(SVRI,PVRI)decreased significantly,throughout the hemofiltration,PaO 2/FiO 2 increased and mean arterial pressure(MAP),pulmonary capillary wedge pressure(PCWP),heart rate(HR),cardiac index(CI),oxygen delivery(DO 2),oxygen consumption(VO 2),oxygen extraction(ExtrO 2)and intrapulmonary shunt(Qs/Ot) did not change significantly.Conclusion Continuous hemofiltration can increase PaO 2/FiO 2 and has no significant effects on hemodynamics and oxygenation.