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目的 :探讨允许性高碳酸血症 (PHC)对重度急性呼吸窘迫综合征 (ARDS)患者肺力学特征的影响。方法 :观察不同潮气量 (VT)条件下 ,10例重度ARDS患者肺力学及动脉和混合静脉血气参数的改变。结果 :当VT 从常规 10～ 12ml/kg降至 6～ 8ml/kg时 ,患者均出现PHC ,动脉氧分压和氧饱和度无显著变化 ,肺内分流率显著升高 (P <0 0 5 ) ,气道平台压力和平均压力均显著降低 ,吸气顺应性曲线中最后 2 0 %的顺应性与总顺应性之比 (C2 0 /C)明显增大。结论 :采用较正常偏低VT 实施PHC ,可防止肺泡过度膨胀 ,是治疗重度ARDS的重要手段
Objective: To investigate the effects of permissive hypercapnia (PHC) on the pulmonary mechanics in patients with severe acute respiratory distress syndrome (ARDS). Methods: The changes of pulmonary mechanics, arterial and mixed venous blood gas parameters in 10 severe ARDS patients under different tidal volume (VT) conditions were observed. Results: When the VT was reduced from 10 ~ 12ml / kg to 6 ~ 8ml / kg, PHC appeared in all patients. There was no significant change in arterial partial pressure of oxygen and oxygen saturation, and pulmonary shunt rate was significantly increased (P <0.05 ), The pressure and mean pressure of airway platform decreased significantly. The ratio of compliance to total compliance (C2 0 / C) of the last 20% of inhalation compliance curves increased significantly. CONCLUSIONS: PHC, which is performed at lower VT than normal, prevents excessive expansion of the alveoli and is an important treatment for severe ARDS