三种呼吸模式对创伤后周围循环和血气的影响

目的：对10例严重的创伤患者行呼吸机治疗，探讨A／C，SIMV和PSV三种模式对周围循环和血气的影响。方法：最初采用A／C模式，逐渐改为SIMV和PSV，每种模式持续120分钟，SIMV频率为A／C的75％，PSV设置在能够达到与A／C相同的呼出气潮气量水平，三种模式氧气浓度均为40％，利用Colin BP308无创心电监护仪和测定中心静脉压并做动脉血气分析获得周围循环和血气参数。结果：与A／C相比，SIMV和PSV有一个降低的PIP，减小的循环阻力，提高的PaO2和SaO2％。结论：与A／C相比，SIMV和PSV对脑内压和周围循环影响小，可增加组织氧摄取率的机会。

Effect of 3 kinds of ventilation modes on peripheral circulation and arterial blood gas analysis parameters in patients with trauma

Objective:To investigate the effect of 3 kinds of mechanical ventilation mode(A/C,SIMV and PSV) on peripheral circulation and arterial blood gas analysis parameters in 10 patients with severe trauma.Methods:Mechanical ventilation treatment was initiated with A/C mode,and gradually was changed to SIMV and PSV mode.Each mode of ventilation was persisted 120 minutes.The frequency of SIMV was 75% of A/C mode.PSV was installed at level in order to maintain the same tide volume level as using A/C mode.The oxygen concentration of 40% was used during 3 modes of ventilation.The central venous pressure and parameters of arterial blood gas analysis were measured.Peripheral circulation was monitored using a noninvasive cardiac hemodynamic monitor.Results:In comparison with A/C mode,SIMV and PSV modes of mechanical ventilation resulted in reduction of resistance of peripheral circulation,lower PIP,and resulted in higher PaO 2 and SaO 2.Conclusion:In comparison with A/C mode,SIMV and PSV modes of mechanical ventilation resulted in less effect on intrathoracic pressure and peripheral circulation,and improved the uptake of oxygen by body tissues.