肺复张在心脏外科的应用

Application of alveolar recruitment maneuver after cardiac surgery

心脏外科手术中的麻醉、体外循环和手术创伤等多种因素均可导致肺组织萎陷,引起低氧血症,延长患者的机械通气时间,增加肺部感染的机会。如何使萎陷肺泡重新开放、改善通气状态,在心脏外科具有重要意义。肺复张技术是指持续增加肺内压力,以使尽可能多的萎陷肺单位复张的机械通气方法,可使肺组织通气/血流比匹配,改善氧合。肺复张在心脏外科的应用尚处于起步阶段,文中将对肺复张的基本原理及其在心脏外科中的应用现状进行综述。

Anesthesia,extracorporeal circulation and traumas in cardiac surgery often lead to microatelectasis,even hypoxemia,which thus induces prolonged mechanical ventilation duration and increased pulmonary infection rate.It is of great importance to reopen the atelectatic alveolar.Lung recruitment maneuver is a kind of mechanical ventilation mode applying sustained high pressure to reopen the atelectatic lung tissue and aiming to balance the ratio of ventilation to perfusion.The application of recruitment maneuver in cardiac surgery is still at an early stage,and a number of problems have not been clarified.In this article,the fundamental principle of recruitment maneuver and the application of it in cardiac surgery is discussed.