机械通气时的心肺交互作用及其评估手段研究进展

Advances in cardiopulmonary interaction during mechanical ventilation and the monitoring means

心脏和肺同属于胸腔内脏器,不仅在解剖上相互关联,在生理功能上也存在相互作用。机械通气通过呼吸机对上气道施加正压,从而对呼吸系统及心血管系统产生不同的影响,进一步影响到血流动力学等诸多方面。评估机械通气对血流动力学等方面的影响对指导重症患者的治疗至关重要,目前常见且有效的评估手段包括动脉脉压变异度、每搏量变异度、下腔静脉呼吸变异度、上腔静脉呼吸变异度、颈内静脉呼吸变异度、呼气末屏气试验等指标。

Heart and lung are not only related in anatomy,but also interact in physiological function.Mechanical ventilation exerts positive pressure on the upper airway and causes different side effects on respiratory system,cardiovascular system and hemodynamic condition.Common assessment tools to evaluate the influence of mechanical ventilation on hemodynamics in critical patients include arterial pulse pressure variation,stroke volume variation,respiratory variation in the inferior vena cava,respiratory variation in the superior vena cava,respiratory variation in the internal jugular vein and end-expiratory occlusion test.