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Effects of oxygen indexes on the diagnosis of acute lung injury
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 11
- DOI:
- 10.3760/j.issn:1671-0282.2006.11.003
- Key Word:
- 氧合指数;吸入氧浓度;呼气末气道正压;急性肺损伤;急性呼吸窘迫综合征
Abstract： 目的 探讨吸入氧浓度(FiO2)和呼气末气道正压(PEEP)对氧合指数(OI)以及急性肺损伤(ALI)、急性呼吸窘迫综合征(ARDS)诊断的影响.方法 监测FiO2=100%、PEEP=0时满足ARDS诊断标准模型犬(10只)和患者(10例)在不同FiO2(PEEP=0,FiO2=100%、FiO2=60%、FiO2=21%或FiO2=30%)和PEEP水平(FiO2=100%,PEEP=0.5 cmH2O、PEEP=10 cmH2O)时OI的变化.结果 OI随着FiO2的降低或PEEP的增高而增大,其中FiO2由60%降至21%(患者为30%)或PEEP由5 cmH2O升至10 cmH2O时OI的变化最显著(P＜0.05);同时随着OI的增大,满足ARDS诊断标准的例数逐渐减少,而符合ALI诊断标准的例数增多,甚至出现OI＞300 mmHg不再符合ARDS或ALI诊断的现象.结论 FiO2和PEEP对OI影响显著,从而直接影响ALI、ARDS的诊断结果.因此ALI、ARDS诊断时应严格限定FiO2和PEEP.
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