摘要
目的 比较在冠状动脉旁路移植术 (CABG)后应用双相正压气道通气 (BiPAP)模式和周期性同步强制式通气 (S IMV)模式对血流动力学和呼吸氧合参数的影响。方法 2 6例术前无其他合并症及手术顺利的CABG患者随机均分为先实施BiPAP模式组和先实施S IMV模式组 ,在术后早期镇静未醒情况下 ,分别在原有呼吸模式和改换相应呼吸模式的 1h后 ,以及再次更换回原有呼吸模式 1h后 ,监测血流动力学、血气分析及其他呼吸参数。结果 两组患者中 ,用BiPAP模式时气道吸气峰压均明显低于用S IMV模式 (P <0 .0 5 ) ,但血流动力学、血气分析及其他呼吸参数的差异无显著性。结论 与S IMV模式相比 ,BiPAP模式可显著降低气道吸气峰压 ,对血流动力学和血气无影响 ,这种模式在CABG术后应用是安全的。
Objective To compare the ventilatory and hemodynamic effects of bip hasic positive airway pressure (BiPAP) ventilation with synchronized intermitten t mandatory ventilation (S-IMV) in sedated patients after coronary artery bypas s grafting (CABG). Methods 26 patients without evidence of preoperative respirat ory dysfunction and an uncomplicated intraoperative course were investigated. Th e patients were randomly assigned to one of the two groups starting either with BiPAP or S-IMV mode. Hemodynamic measurements and blood gas analysis were perfo r med during sedation with 2.0 mg·kg -1·h -1 propofol in the primary mode, after wards switching to the alternative ventilatory mode, and again to the primary mo de. Results Inspiratory peak pressure decreased significantly during BiPAP in p atients of both groups (P <0.05). Hemodynamic parameters, blood-gas analysi s and other ventilatory parameters did not vary with the ventilatory mode. Conclusion BiPAP ventilation has no significant differentiating effects on hemodynamics a nd pulmonary gas exchange compared with S-IMV when used for ventilatory suppor t in patients after CABG and thus it is safe and reliable.
出处
《上海医学》
CAS
CSCD
北大核心
2004年第10期710-712,共3页
Shanghai Medical Journal