Ventilatory and hemodynamic effects of continuous positive airway pressure in dogs with acute cardiogenic pulmonary edema
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES
- Issue:
- 6
- DOI:
- 10.3760/j:issn:1001-0939.2005.06.007
- Key Word:
- 肺水肿,心源性;持续气道正压;胸腔负压;中心静脉压;心输出量
Abstract： 目的研究持续气道正压(CPAP)通气对急性心源性肺水肿(ACPE)犬呼吸及循环功能的影响.方法分别监测10条犬健康状态及ACPE发生后自主呼吸、5 cm H2O(1 cm H2O=0.098 kPa)、10 cm H2O、15 cm H2O CPAP时的胸腔负压(Pt)、中心静脉压(CVP)、心输出量(CO)、平均动脉压(BPm)、肺动脉楔压(PAWP).结果与健康状态相比,ACPE犬呼吸增强、增快,Pt由-(4.90±0.09)cm H2O 上升至-(10.90±0.75)cm H2O,CVP由(10.1±0.4)mm Hg下降至(8.0±0.7)mm Hg,CO由(1.52±0.13)L/min下降至(0.85±0.09)L/min,PAWP升高(P均＜0.05).CVP与Pt变化呈正相关(r=0.78,P<0.01).5及10 cm H2O CPAP时Pt值恢复至-(6.53±0.11)cm H2O和-(5.14±0.25)cm H2O,呼吸形式基本恢复正常,CVP升至(11.6±0.7)mm Hg和(14.2±0.2)mm Hg,CO增加至(1.45±0.11)L/min和(1.24±0.11)L/min,其中5 cm H2O CPAP组PAWP下降(P均＜0.05).15 cm H2O CPAP时,呼吸浅快,Pt为-(0.82±0.37)cm H2O,CO为(0.82±0.07)L/min,其他血流动力学指标皆恶化(P均＜0.05).结论犬ACPE发生时,呼吸运动显著增强,Pt升高,并导致CVP和CO的下降;适当CPAP通过改善呼吸功能,调节Pt改善ACPE犬的心功能.
- [1]朱蕾,戎卫海,钮善福,等.经面罩机械通气治疗急性肺水肿的疗效观察[J].2002,(4).
- [2]施新猷主编 施新猷编.医学动物实验方法[M].1986.
- [3]M R, Pinsky,G M, Matuschak,M, Klain.Determinants of cardiac augmentation by elevations in intrathoracic pressure.[J].1985,58.
- [4]Crane SD,Gilligan P,Gray AJ.Randomised controlled comparison of continuous positive airways pressure, bilevel non-invasive ventilation, and standard treatment in emergency department patients with acute cardiogenic pulmonary oedema.[J].2004,21(2).
- [5]M T, Naughton,M A, Rahman,K, Hara,etc.Effect of continuous positive airway pressure on intrathoracic and left ventricular transmural pressures in patients with congestive heart failure.[J].1995,91.