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Effects of positive end-expiratory pressure on lung recruited volume and oxygenation in patients with acute respiratory distress syndrome
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 7
- DOI:
- 10.3760/j.issn:1003-0603.2004.07.005
- Key Word:
- 急性呼吸窘迫综合征;呼气末正压;肺复张容积;氧合
Abstract： 目的评价呼气末正压(PEEP)对急性呼吸窘迫综合征(ARDS)肺复张容积的影响 ,探讨ARDS患者PEEP的选择方法. 方法以11例血流动力学稳定、接受机械通气的ARDS患者为研究对象,采用压力容积曲线法分别测定PEEP为5、10、15 cm H2O(1 cm H2O=0.098 kPa)时的肺复张容积,观察患者动脉血气、肺机械力学和血流动力学变化.结果 PEEP分别5、10和15 cm H2O时肺复张容积分别为(40.2±15.3)m l、(123.8±43.1)ml和( 178.9±43.5)ml,随着PEEP水平的增加,肺复张容积亦明显增加(P均<0.05).动脉氧合指数也随着PEEP水平增加而增加,且其变化与肺复张容积呈正相关(r=0.483, P< 0.01).不同PEEP条件下,患者的肺静态顺应性无明显变化(P>0.05).将患者按有无低位转折点(LIP)分为有LIP组与无 LI P组,两组患者的肺复张容积都随着PEEP水平的增加而增加,其中PEEP 15 cm H2O时LIP 组患者的肺复张容积大于无LIP组(P<0.05).结论 PEEP水平越高,肺复张容积越大,肺复张容积增加与动脉氧合指数的变化呈正相关.
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