犬呼吸窘迫综合征反比通气与常规通气氧代谢及心肺效应的比较

Cardiopulmonary effects of inverse ratio ventilation in canine model of acute respiratory distress syndrome

目的比较反比通气与常规容量控制通气(常规通气)时氧代谢、心排血功能、呼吸动力学和氧代谢的变化,探讨反比通气的临床应用价值。方法复制犬急性呼吸窘迫综合征(ARDS)模型,随机分为对照组、常规通气组和反比通气组,机械通气6h后测定氧转运、氧消耗、氧合指数、心排指数、吸气峰压、平均气道压、气道阻力、胸肺动态顺应性等。结果反比通气组氧转运、氧消耗、氧合指数、心排指数、平均气道压和胸肺动态顺应性显著高于常规通气组,气道峰压、气道阻力显著低于常规通气组,差异有统计学意义(P<0.05)。结论反比通气在氧代谢、心排血功能、呼吸动力学、氧代谢方面优于常规通气,有一定的临床应用价值。

Objective To campare the changes of oxygen metabolism,cardiac index,respiratory mechanics and oxygen index in the canine during conventilation and inverse ratio ventilation.Methods The oleic acid induced acute respiratory distress syndrome（ARDS） models were made in 21 canines.The expermental animals were divided into 3 groups： control group,conventional and inverse ratio ventilation groups,6 h later,oxygen delivery（DO2）,oxygen consumption（VO2）,cardiac index（CI）,peak inspiration pressure（PIP）,mean airway pressure（MAP）,airway resistance（Raw）,dynamic compliance（Cd） and oxygen index were determined.Results DO2,VO2,CI,MAP and Cd in inverse ratio ventiolation grorp were higher than those in conventional ventilation group.PIP and Raw were significantly lower in invese ratio ventilation group than those in conventional ventilation.Conclusion Inverse ratio ventilation is superior to conventioal ventilation in improving oxygen metabolism,cardiac index,respiratory mechanics and oxygen index,and thus could be useful for treatment of ARDS.