呼气末正压对中心静脉压的影响

Effect of positive end-expiratory pressure on central venous pressure of the patients undergoing mechanical ventilation

目的探讨机械通气时呼气末正压(PEEP)对中心静脉压(CVP)的影响。方法采用前瞻性自身对照研究。选取27例机械通气患者,经右锁骨下静脉置入深静脉导管,PEEP设0、3、6、9、12和15 cmH_2O 6个水平,记录不同PEEP水平时的CVP、MAP、HR。结果 PEEP与CVP呈显著正相关;PEEP增加前后的HR和MAP变化不具显著性差异。结论使用CVP指导液体治疗的关键是观察CVP值的动态变化趋势。

Objective To evaluate the effect of positive end - expiratory pressure （PEEP） on central venous pressure （CVP） of the patients undergoing mechanical ventilation. Methods This is a prospective self - controlled study. 27 patients were enrolled in this study with MY and CVP measurement in intensive care unit from August 2007 to April 2009. EVP, heart rate（HR） , mean arterial pressure （ MAP）, were obtained simultaneously under different PEEP conditions of 0 ,3,6,9,12 and 15 cm H2O. Results There was a significant positive correlation between CVP and PEEP （ r = 0. 989 ）. No significant effects of PEEP on HR and MAP were found （ P 〉 0. 5 ）. Conclusion Dynamic trend of CVP is the key to guide the fluid therapy.