成比例辅助通气与常规机械通气对ARDS家猪模型的疗效比较  

The effect of proportional versus assisted and controlled ventilation volume control on oxygenation in pig with ARDS

作　　者：高敏 徐静[2] 张兴文[2] 韩小彤[2] 樊麦英[2] 宁凤玲 Gao Min;Xu Jing;Zhang Xingwen;Han Xiaotong;Fan Maiying;Ning Fengling(Respiratory Therapy Department,Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University;Emergency Department,Hunan Provincial People’s Hospital/The First Affiliated Hospital of Hunan Normal University)

机构地区：[1]湖南省人民医院/湖南师范大学附属第一医院呼吸治疗专科 [2]湖南省人民医院/湖南师范大学附属第一医院急诊科

出　　处：《实用休克杂志（中英文）》2021年第1期24-27,共4页Journal of Practical Shock

基　　金：长沙市科技局(项目编号:ZD1702034)。

摘　　要：目的本研究通过使用生理盐水灌洗建立急性呼吸窘迫综合征(ARDS)家猪模型,评价成比例辅助通气(PAV+)模式对ARDS急性期家猪的疗效,旨在为治疗ARDS急性期呼吸支持治疗提供新的方法和依据。方法研究选取10只健康家猪,通过生理盐水给气管内灌注制作ARDS家猪模型,并随机分为两组,即PAV+组和常规机械通气(A/C VC)组,两组分别记录造模成功后的血流动力学、呼吸力学、血气分析的指标。结果对于ARDS家猪,在机械通气辅助治疗(VT)相似的情况下,PAV+模式下的气道峰压、平台压明显低于A/C VC模式下的气道峰压及平台压,且SpO_(2)显著优于A/C VC模式下SpO_(2)。结论与A/C VC比较,PAV+模式能以较低的峰压达到相似的通气效果且氧合功能优于A/C VC,更适合应用于ARDS患者。Objective To establish a model of ARDS in pigs with normal saline lavage,in order to evaluate the efficacy of Proportional assist ventilation(PAV+)versus assisted and controlled ventilation volume control(A/C VC)in the treatment of ARDS in pigs at the acute stage,so as to provide a new method and basis for respiratory support treatment of ARDS in the acute stage.Methods A total of 10 healthy pigs were randomly divided into two groups:PAV+ group and A/V VC group.The hemodynamics,respiratory mechanics and blood gas analysis indexes of the two groups were recorded after the model was established.Results For ARDS pigs,PIP in PAV+ mode was significantly lower than PIP in A/C VC mode under similar VT condition,and PaO_(2)/FiO_(2) ratio was significantly better than that in A/C VC mode,while the hemodynamics and blood gas changes were not significantly different.Conclusions Compared with A/C VC,PAV+can achieve similar ventilation effect at lower peak pressure and has better oxygenation function than A/C VC,so it is more suitable for ARDS patients.

关 键 词：急性呼吸窘迫综合征 成比例辅助通气 控制辅助通气 

分 类 号：R563.8[医药卫生—呼吸系统] R-332[医药卫生—内科学]