IPPV和APRV通气模式对健康和ALI犬心肺功能影响的比较  

Comparison of the influence to cardiac-pulmonary function of health and ALI dogs by IPPV and APRV modes

作　　者：方智野[1,2] 白春学[1,2] 宋元林[1,2] 洪群英[1,2] 钮善福[1,2] 

机构地区：[1]上海医科大学呼吸病研究所 [2]上海医科大学中山医院肺科

出　　处：《中国急救医学》1999年第2期74-77,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的比较间歇正压通气（ＩＰＰＶ）和气道压力释放通气（ＡＰＲＶ）模式对健康和急性肺损伤（ＡＬＩ）犬心肺功能的影响。方法对健康和ＡＬＩ犬，分别用ＩＰＰＶ和ＡＰＲＶ模式通气，观察通气期间血流动力学、血气和呼吸生理的变化。结果对健康犬，采用相似的峰压进行通气，ＡＰＲＶ的平均气道压高于ＩＰＰＶ，除平均肺动脉压外，对血气和血流动力学影响，两者差别不显著。对ＡＬＩ犬，采用相似的平均气道压通气，ＩＰＰＶ的峰压显著高于ＡＰＲＶ，而血流动力学、血气变化相似，ＡＰＲＶ时ＰａＯ２／ＦｉＯ２比值显著优于ＩＰＰＶ时。结论ＡＰＲＶ与ＩＰＰＶ相比，能以较小的峰压达到相似的通气效果且氧合功能优于ＩＰＰＶ。Objective In order to compare the influence to cardiac-pulmonary function of health and ALI dogs by IPPV and APRV ventilatory modes. Methods Two different ventilatory modes (intermittent positive pressure ventilation(IPPV) and airway pressure release ventilation(APRV)were given to ten health and acute lung injury (ALI)dogs .During the ventilation,the parameters of hemodynamics,blood gas and respiratory physiology were recorded.Results For the health dogs, when the peak airway pressure were similar ,the mean airway pressure of APRV was notably higher than that of IPPV,while the influence to hemodynamics and blood gas were similar except the parameter mean pulmonary artery pressure .For ALI dogs ,the peak airway pressure of IPPV was notably higher than that of APRV, PaO 2/FiO 2 of APRV was notably higher than of IPPV ,while the mean airway pressure of two modes and the influence to hemodynamics and blood gas were similar .Conclusion The oxygenation of APRV is better than that of IPPV ,and with lower peak airway pressure ,APRV is more fit for ALI patients. [

关 键 词：间歇正压通气 APRV 心肺功能 肺损伤 ALI 

分 类 号：R563.05[医药卫生—呼吸系统] R459.6[医药卫生—内科学]