低心排综合征的机械通气治疗

Treatment of low output syndrome with mechanicalventilation

我院１８８例心内直视手术后发生低心排综合征（ＬＯＳ）３４例，使用机械通气治疗的效果较好。体会为：必须了解ＬＯＳ与肺功能的因果关系。选用定容型通气机、综合心肺两方面的因素、调整潮气量、氧浓度、呼吸频率及吸气与呼气时间比。在应用机械通气改善肺功能、纠正低氧血症与酸碱紊乱的同时，须考虑其正压作用对心排出量的影响，并采取相应预防措施。严重肺功能不全合并低氧血症而加重ＬＯＳ者，可在监控下给予呼气未正压通气（ＰＥＥＰ）治疗。

Of the 188 cases of open-heart surgery in ourhospital,34 had low output syndrome(LOS)whichwasef effectively treated With mechanical ventilation.Our expehence was asfollows:(1)the relation-ship between LOs and pulmonary function should befully understood;(2)volume limited ventilation wasthe choice for LOS;(3)both cardiac and pulmonaryfunctions should be considered in adjusting the tidalvolume,oxygen cncentration , respiratory rate andthe time ratio of inspiration to expiration;(4)the ef-fect of positive pressure on cardiac output should beconsidered and the corresponding preventive meas-ures be taken while using mechanical ventilationto imDrove the pulmonary function and correct theacid-base dysturbance;(5)with careful monitoring,PEEP was em ployed in the patients with severepulmonary dysfunction accom panied by hypoxiaWhich exacerbated LOS:(6)the use of SIMV washelp ful for the recovery of cardiopulmonary functionand the weaning of mechanical ventilation.