严重脑外伤继发ARDS患者机械通气,PEEP与ICP和MAP的变化相关性研究  

Study on the Correlation of PEEP,ICP and MAP in Patients with ARDS Undergoing Mechanical Ventilation Secondary to Severe Traumatic Brain Injury

作　　者：马雅玲 吴迪[1] MA Ya-ling;WU Di(Intensive Care Unit,Tianjin Huanhu Hospital,Tianjin 300350)

机构地区：[1]天津市环湖医院重症监护室,天津300350

出　　处：《中国医疗器械信息》2020年第24期19-21,共3页China Medical Device Information

摘　　要：目的:继发于严重的外伤性脑损伤的急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS)的发病率接近20%和10%。这两种情况的出现增加了患者的死亡风险和神经系统远期不良预后的可能性。本研究目的在于对严重脑外伤继发ARDS的患者镇静后行机械通气,调整PEEP观察对ICP和平均动脉压(MAP),CPP的影响。方法:选择符合入组条件的严重脑外伤患者共31例,同时行ICP监测和机械通气,以1cmH2O为单位在5~12cmH2O范围内滴定式调节PEEP。记录患者每次调整PEEP后,对应的MAP、ICP,计算CPP。结果:在一定范围内调整后,差异有统计学意义(P<0.05)。结论:需严密监测ICP和CPP,MAP情况下,滴定PEEP至最佳水平。Objective:The incidence of acute lung injury(ALI)and acute respiratory distress syndrome(ARDS)secondary to severe traumatic brain injury(TBI)is close to 20%and 10%.The presence of both conditions increases the risk of death and the likelihood of long-term poor neurological outcomes.The purpose of this study was to observe the effect of mechanical ventilation and PEEP adjustment on ICP,MEAN arterial pressure(MAP)and CPP in patients with ARDS secondary to severe brain injury.Methods:A total of 31 patients with severe traumatic brain injury were selected,and ICP monitoring and mechanical ventilation were performed at the same time.PEEP was titrated within the range of 5-12 cmh2O with 1cmH2O as the unit.The MAP,ICP and CPP were calculated after each adjustment of PEEP.Results:After adjustment within a certain range,the difference was statistically significant(P<0.05).Conclusion:ICP,CPP and MAP should be closely monitored to titrate PEEP to the best level.

关 键 词：脑外伤 ARDS 机械通气 PEEP ICP MAP CPP 

分 类 号：R61[医药卫生—外科学]