压力调节容量控制通气对急性肺损伤血流呼吸动力学和氧代谢的影响

目的研究压力调节容量控制通气(PRVC)和间歇正压通气(IPPV)对急性肺损伤(ALI)患者血流动力学、呼吸动力学和氧代谢的影响.方法对30例ALI患者分别进行呼吸末正压(PEEP)0、5、10 cmH2O水平下的PRVC和IPPV通气,测定其血流动力学、呼吸力学和氧代谢参数.结果比较PRVC和IPPV二种通气模式,同一水平PEEP其血流动力学无明显差异(P＞0.05),但吸气峰压(PIP)、肺动态顺应性(Cst)、动脉氧分压(PaO2)和氧供(DO2)均有明显差异(P＜0.05).结论PRVC与IPPV相比能明显降低PIP,增加Cst,增加DO2.

Effect of pressure regulated volume- controlled ventilation mode on hemodynamics, pneumodynamics and the metabolism of oxygen in acute lung injury cases

Objective To study hemodynamics , pneumodynamics and the metabolism of oxygen in acute lung injury (ALI) patients who accepted pressure regulated volume-controlled ventilation (PRVC) and intermittent positive pressure ventilation (IPPV). Methods Thirty ALI patients were ventilated with PRVC and IPPV, and the PEEP was 0, 5, 10 cmH_2O , respectively. The hemodynamics,pneumodynamics and the metabolism of oxygen in the two groups were tested. Results We compared IPPV modality with PRVC modality when PEEP was the same degree, there was no significant difference in hemodynamics, but there was significant difference in peak inspiratory pressure, pulmonary dynamics compliance and the partial pressure of oxygen in artery and DO_2. Conclusion Compared with IPPV modality , PRVC modality can decrease inspiratory peak and increase pulmonary compliance and DO_2.