四种通气模式对严重烟雾吸入伤犬早期肺通气功能的影响

Effect of four mechanical ventilation modes on pulmonary ventilation in early stage after severe smoke inhalation injury in dogs.

目的 观察四种通气模式对严重烟雾吸入伤犬早期肺通气功能的影响。方法 35只犬分为PEEP组、PC组、CPAP组、IRV组和致伤对照组。伤后 1h开始连续 2 4h机械通气。FiO2 =0 .4 ,PIP =1 6kPa ,PEEP CPAP =0 6kPa ,除IRV组I∶E =2∶1外 ,其他通气组I∶E =1∶2。结果 与对照组相比 ,四种机械通气模式可显著增高VT,降低RR、MV、VD VT,减缓Cdyn下降幅度和QS QT上升幅度 ;伤后 2 4hCPAP组和PEEP组Cdyn和QS QT 仍分别显著高于和低于对照组。结论 本实验所采用的通气模式及参数于烟雾吸入伤早期持续 2 4h通气治疗可通过增加肺泡有效通气量 ,改善肺泡通气 灌流比等作用 ,不同程度地减轻减缓肺泡萎陷及肺不张的发生发展进程 ,其中持续气道正压 (PEEP CPAP)

Objective To observe the effect of four mechanical ventilation modes on pulmonary ventilation in early stage after severe smoke inhalation injury in dogs. Methods 35 healthy dogs were divided into 5 groups: PEEP,PC,CPAP,IRV,control(n=7 in each group). Continuous 24 hours mechanical ventilation were performed one hour after smoke inhalation injury .FiO2=0.4,PIP=1 6kPa,PEEP/CPAP=0 6kPa, I∶E=2∶1 in IRV group,I∶E=1∶2 in other ventilation groups. Results Comparing with the control group,four modes of mechanical ventilation could result in increment of tidal volume, decrement of respiratory rate, minute ventilation, V D/V T, attenuation of decreasing scope of dynamic compliance and increasing scope of Q S/Q T. 24 hours after injury dynamic compliance and Q S/Q T in CPAP and PEEP groups separately higher or lower significantly than that in the control group. Conclusion The modes and parameters with which continuous 24 hours mechanical ventilation in this study could attenuate the severity and retard the development of alveolar collapse and atelectasis by increasing alveolar oxygen delivery capacity,improving the ratio of alveolar ventilation/perfusion and other effects . In which continuous positive airway pressure (PEEP/CPAP) have more beneficial effects .