双重控制及压力控制容量控制通气模式在治疗急性呼吸窘迫综合症中之比较

目的:探讨应用双重控制模式(dual control modes)与容控和压控模式的机械通气在治疗急性呼吸窘迫综合症(ARDS)中的效果比较。方法:对81例ARDS病人随机分组给予容控模式(volume control mode)、压控模式(pressure control mode)以及双重控制模式通气,采用分组对照的方法监测病人机械通气参数、通气、换气和血流动力学指标的变化。结果:双重控制模式气道压力小于容控通气,与压控通气组无明显差异。RR、分钟通气量(MV)、氧合指数(OI)、血流动力学指标三种模式无明显差异。无一例出现气压伤。结论:双重控制模式结合了容控通气与压控通气的特点,提高了人机协调性,但与传统通气模式相比,治疗中没有绝对的优势。只有合理地采用个体化肺保护通气策略(LPV),才能取得良好的通气效果。

The use of Dual control modes of mechanical ventilation in patients with acute respiratory distress syndrome

Objective To investigate the effect of dual control modes of mechanical ventilation in patients with ARDS.Methods ARDS 81 cases with mechanical ventilation used volume control modes、pressure control modes and dual control modes in turn randomly.Period of time later,monitored the change of the hemodynamic、ABG and the ventilatory parameters.Results The ventilation pressure of dual control modes was less than volume control modes and close to pressure control modes.RR、MV、oxidation index(OI) and hemodynamic have no obvious difference in three modes.Barotraumas didn't occur.Conclusion Dual control modes combines the characteristics of volume control mode and pressure control mode,improve the harmony between the patients and the ventilator.But be compared with traditional ventilation,dual control modes are in defect of predominance.None but treating with lung protective ventilatory strategies(LPV) can achieve the good ventilation effect.