新型通气模式对健康犬心肺功能的影响

Cardiopulmonary effects of four modes of mechanical ventilation in dogs

目的 比较研究双水平气道压力调节通气(BIPAP)、气道压力释放通气(APRV)、反比通气(IRV)和间歇气道正压通气(IPPV)对健康犬心肺功能的影响。方法 观察健康犬应用四种通气模式在0、0.5及1kPa呼气末压(EEP)时呼吸力学、血流动力学及血气分析各参数变化。结果EEP从0增加到0.5和1kPa后,各通气模式的气道峰压(Ppeak)和平均气道压(mPaw)均明显升高,但以BIPAP的升高幅度最小,平均肺动脉压(mPAP)最低。与IPPV比较,虽然APRV和IRV的Ppeak略低,但mPaw却明显升高,同时伴较大幅度的mPAP升高。结论 无肺损伤时,BIPA P对心肺功能的不利影响最小。与IPPV比较,APRV和IRV对气道压力和血流动力学的影响无明显优点。

Objective To compare the cardiopultnonary effect of biphasic positive airway pressure (BIPAP) .airway pressure realease ventilation(APRV), inverse ratio ventilation( IRV), and intermittent positive pressure ventilation(IPPV) .Methods Airway pressure, hemodynamics and blood gases were measured during the four ventilatory modalities with 0, 0.5,1 kPa external end-expiratory pressure (EEP) in dogs.Results In dogs without lung injury, airway pressure and mean pulmonary artery pres-sure(mPAP) during BIPAP are lowest in the four ventilation modes. Compared with IPPV,although peak airway pressure are lower during APRV and IRV, their mean airway pressure and mean pulmonary artery pressure are all increased markedly.Conclusion In the four ventilation modes,BIPAP has least adverse impact on cardiopulmonary function.Compared with IPPV, APRV and IRV have no more advantage on airway pressure and hemodynamics in dogs without lung injury.