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应用机械通气呼气末正压治疗急性呼吸衰竭,有利亦有害。它可使不张的肺泡恢复通气,提高功能残气量、肺应变性和动脉血氧分压;但亦能使肺泡过度扩张,肺应变性减低,甚至引起肺泡破裂发生气胸;还能阻碍静脉回流,减低心排出量。作者提出以应变性作为最适宜的呼气末压力的指标。作者对15例需作持续机械通气的急性呼吸衰竭者进行观察。15例中男13例,女2例,年龄24～74岁,平均49岁。5例为严重创伤,3例为大手术后,其余为代谢或感染等病因所致。均用容量控制型呼吸器作辅助通气。潮气量固定在13～15毫升/公斤体重。吸
The application of mechanical ventilation end-expiratory pressure treatment of acute respiratory failure, both beneficial and harmful. It can restore atelectasis alveolar ventilation, improve functional residual capacity, pulmonary strain and arterial partial pressure of oxygen; but also can make the alveolar hyperextension, reduced lung strain, and even pneumothorax caused by rupture of the alveolar; also hinder venous return , Reduce cardiac output. The authors propose using strain as the most appropriate indicator of end-expiratory pressure. The authors observed 15 patients with acute respiratory failure requiring continuous mechanical ventilation. 15 cases of male 13 cases, 2 females, aged 24 to 74 years, mean 49 years. 5 cases of severe trauma, 3 cases of major surgery, the remaining due to metabolic or infection caused by other causes. All use volume-controlled respirators for assisted ventilation. Tidal volume fixed at 13 to 15 ml / kg body weight. Suck