侧卧位机械通气对胸外伤急性呼吸衰竭患者血氧及循环的影响

Impact of lateral position mechanical ventilation on blood oxygen and cir-culation of chest trauma patients with acute respiratory failure

目的探讨侧卧位机械通气对胸外伤急性呼吸衰竭患者血氧及循环的影响。方法选取2014年1月~2015年10月胸外伤引起的急性呼吸衰竭患者20例进行侧卧位机械通气。测定侧卧位前、侧卧位1 h、恢复仰卧位后1 h患者动脉血气及HR、MAP、CVP、CO、CI、SV、SVV等循环指标变化。结果患者改变体位后动脉血PaCO_2无明显变化,侧卧位1 h后比侧卧位前PaO_2、PaO_2/FiO_2明显升高（P〈0.05）,恢复仰卧位后1 h后比侧卧位前PaO_2、PaO_2/FiO_2仍明显升高（P〈0.05）;体位变动对MBP、HR、CVP及CO、CI、SV、SVV等指标比较,差异无统计学意义（P〉0.05）。结论侧卧位机械通气能改善胸外伤急性呼吸衰竭患者的氧合状况,对血流动力学无明显影响。

Objective To explore the impact of lateral position mechanical ventilation on blood oxygen and circulation of chest trauma patients with acute respiratory failure.Methods 20 chest trauma patients with acute respiratory failure were conducted lateral position mechanical ventilation from January 2014 to October 2015.Arterial blood gas,cycle indicator changes liked HR,MAP,CVP,CO,CI,SVand SVV beforelateral position,1 h after lateral position and 1 h after recovery lateral position were tested.Results The arterial blood PaCO_2 had no obvious changes after change position.1 h after lateral position,the PaO_2 and PaO_2/FiO_2 obvious increased than before lateral position（P〈0.05）.1 h after recovery lateral position, the PaO_2 and PaO_2/FiO_2 still obvious increased（P〈0.05）;Changed position had no impact on HR,MBP,CVP,CO,CI,SV and SVV（P〉0.05）.Conclusion Lateral position mechanical ventilation can improve the oxygenation status of chest trauma patients with acute respiratory failure,but have any obvious impact on hemodynamics.