心肺复苏仪按压过程中不同通气模式的效果及对潮气量的影响  

Effects of different ventilation modes on tidal volume during cardiopulmonary resuscitation apparatus

作　　者：叶朗熙 吴国新 陈盛安 YE Langxi;WU Guoxin;CHEN Sheng'an(Emergency Department,Sixth Affiliated Hospital of South China University of Technology(Foshan City Nanhai District People's Hospital),Foshan Guangdong 528200,China)

机构地区：[1]华南理工大学附属第六医院(佛山市南海区人民医院)急诊科,广东佛山528200

出　　处：《中国急救复苏与灾害医学杂志》2024年第5期565-568,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：广东省医学科学技术研究基金(编号:B2022203)。

摘　　要：目的探讨心肺复苏仪按压过程中不同通气模式的效果及对潮气量的影响,找出自动机械复苏时最佳的机械通气策略。方法选取2022年10月—2023年6月华南理工大学附属第六医院收治的60例心搏骤停患者为研究对象,根据通气模式将患者分为压力控制通气(PCV)模式组(30例)与容量控制通气(VCV)模式组(30例),PCV组设置通气压力12~23 cmH2O;VCV组设置VT=300~750 mL。比较两组的心肺复苏成功率与未成功率、呼气末二氧化碳分压(P_(ET)CO_(2))水平、心肌功能损伤指标、两组按压前后潮气量(VT)、不同呼吸频率下两组VT。结果VCV组的复苏成功率为73.33%,高于PCV组46.67%(P<0.05);整体分析,两组患者的P_(ET)CO_(2)水平组间、时间、交互比较,差异有统计学意义(P<0.05),VCV组在复苏1 h、复苏2 h的P_(ET)CO_(2)水平均高于PCV组(P<0.05);复苏后2 h,VCV组患者的心肌肌钙蛋白I(cTnI)、脑钠肽(BNP)、血乳酸水平均低于PCV组(P<0.05);按压后PCV组患者的VT降低幅度大于VCV组;不同呼吸频率下PCV组实测VT低于VCV组。结论与PCV模式相比,VCV模式下心肺复苏成功率较高,更能改善心肺复苏患者的呼吸功能,减少心肌损伤,同时能更好地控制潮气量,提高通气效果,更好满足患者的通气需求。Objective To study the effects of different ventilation modes on tidal volume(VT)during cardiopulmonary resuscitation(CPR),and find out the best mechanical ventilation strategy during automatic mechanical resuscitation.Methods A total of 60 patients with cardiac arrest who were admitted to the Sixth Affiliated Hospital of South China University of Technology from October 2022 to June 2023 conducted on this study.All patients were divided into pressure-controlled ventilation(PCV)mode group(30 cases)and volume-controlled ventilation(VCV)mode group(30 cases)according to the ventilation mode.The ventilation pressure of PCV group was 12-23 cmH2O;In the VCV group,VT was 300 to 750 mL.The successful and unsuccessful CPR,end-expiratory partial pressure of carbon dioxide(P_(ET)CO_(2))level,myocardial function injury index,VT before and after compression,and VT at different breathing rates were compared between the two groups.Results The success rate of CPR in VCV group was 73.33%,higher than that in PCV group(46.67%)(P<0.05).There were statistically significant differences in the time and interactive comparison of P_(ET)CO_(2)level between the two groups(P<0.05).P_(ET)CO_(2)level in VCV group was higher than that in PCV group at 1 hour and 2 hours of CPR(P<0.05).At 2 hours after CPR,the levels of cardiac troponin I(cTnI),brain natriuretic peptide(BNP)and blood lactic acid in VCV group were lower than those in PCV group(P<0.05).After compression,the VT reduction in PCV group was greater than that in VCV group.The measured VT of PCV group was lower than that of VCV group at different respiratory frequencies.Conclusion VCV mode has a higher success rate of CPR as compared with PCV mode of the patients with CPR in our study.It could be beneficial for patients to improve respiratory function,reduce myocardial damage,better control VT,and enhance ventilation effect.

关 键 词：心肺复苏仪 通气模式 效果 潮气量 

分 类 号：R605.97[医药卫生—急诊医学]