机械通气状态下呼气末正压与中心静脉压的相关性研究

Relevance study on positive end expiratory pressure and central venous pressure during mechanical ventilation

目的探讨机械通气时呼气末正压与中心静脉压的相关性。方法选择监护室进行机械通气并监测中心静脉压的患者47例,采用自身对照法,观察患者呼气末正压在0、3、6、9、12、15 cmH2O(1 cmH2O=0.098 kPa)条件下中心静脉压的变化,数据以均数+标准差(-x±s)表示,统计分析采用方差、相关及回归分析。结果中心静脉压随呼气末正压水平升高而递增,方差分析显示呼气末正压≤3 cmH2O时,测得的中心静脉可以视为实际CVP。并以呼气末正压为自变量X,中心静脉压测量值为因变量Y,可计算出直线回归方程Y=10.9143+0.1581X(R2=0.9328)。结论呼气末正压与中心静脉压呈显著正相关,即呼气末正压会影响中心静脉压测量的准确性。

Objective To study the relevance of positive end expiratory pressure and central venous pressure during mechanical ventilation. Method Choose 47 patients undergoing mechanical ventilation in ICU and monitoring their central venous pressure. Observe the change of central venous pre.ssure at PEEP 0,3,6,9,12and 15 cmH2O （1 emil2O= 0. 098 kPa） by self- comparison. Analyze the data by eovariance, correlation and regression analysis and present it by average ＋ deviation （x ^-± s ）. Result Central venous pressure increases as PEEP level rise. Covariance analysis indicates that the tested CVP value can be seen as the real CVP value when PEEP≤3 cmH2O. The linear regression equation Y= 10. 9143 ＋ 0. 1581X can be got when taking PEEP as independent variable X and CVP as dependent variable Y. Conclusion There is positive correlation between positive end - expiratory pressure and central venous pressure. Positive end expiratory pressure will affect the accuracy of monitoring central venous pressure.