论文部分内容阅读
目的:探讨允许性高碳酸血症(PHC)治疗重度急性呼吸窘迫综合征(ARDS)的治疗效应。方法:观察不同潮气量(V_T)条件下,10例重度ARDS患者的肺力学、血液动力学和氧动力学参数。结果:V_T从常规水平(10～12ml/kg)降至小V_T(6～8ml/kg)时,患者均出现PHC,PaO_2和SaO_2无显著变化,但肺内分流率显著升高(P<0.05)。气道平台压力显著降低。吸气最后20%的顺应性与总顺应性之比(C_(20)/C)明显增大。MAP、PAP无明显变化,但SVRI显著降低(P<0.05)。CI和DO_2均显著增高(P<0.05),VO_2无显著变化。结论:PHC可防止肺泡过度扩张,同时提高CI和DO_2,是治疗重度ARDS重要手段。
Objective: To investigate the therapeutic effect of permissive hypercapnia (PHC) on severe acute respiratory distress syndrome (ARDS). Methods: The pulmonary mechanics, hemodynamics and oxygen dynamics parameters of 10 patients with severe ARDS under different tidal volume (V_T) were observed. Results: There was no significant change in PHC, PaO_2 and SaO_2, but the intrapulmonary shunt rate was significantly increased (P <0.05) when V_T was decreased from normal level (10 ~ 12ml / kg) to small V_T (6 ~ 8ml / ). Airway platform pressure decreased significantly. The ratio of compliance to total compliance (C 20 / C) for the last 20% of inhalation increases significantly. MAP and PAP had no significant change, but SVRI decreased significantly (P <0.05). CI and DO_2 were significantly increased (P <0.05), VO_2 no significant change. Conclusion: PHC can prevent over-expansion of alveoli and increase CI and DO_2, which is an important method for the treatment of severe ARDS.