呼气末正压对机械通气病人中心静脉压的影响

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

目的 评价呼气末正压 (PEEP)如何影响机械通气病人的中心静脉压 (CVP)。方法 监测 4 0例机械通气病人在不同水平PEEP(0～ 2 0cmH2 O)时的CVP值 ,同时记录心率、平均动脉压、血氧饱和度。统计学处理所有计量资料以及CVP与PEEP的相关性分析。结果 CVP值随PEEP值的增加而增高 ,且CVP值的变化与PEEP值的变化呈显著性正相关 ,r =0 990 8。结论 虽然机械通气时CVP值受PEEP的影响而增高 ,但监测CVP仍可作为指导机械通气病人液体治疗的有效方法。

Objective To evaluate the effect of positive end-expiratory pressure (PEEP) on central venous pressure (CVP) of the patients undergoing mechanical ventilation. Methods Central venous catheters were inserted in patients via right subclavian vein and via left jugular vein with Seldinger technique for measuring CVP. CVP, heart rate (HR), mean arterial pressure (MAP) and oxygen saturation of arterial blood (SaO 2) at various PEEP levels were recorded. Results There were increases of CVP accompanied with PEEP increment, and there was a significant positive correlation between CVP and PEEP (r=0.9908).No significant effects of PEEP on HR and MAP were found ( P >0.5). A significant increase of oxygen saturation of arterial blood was seen when PEEP≥16 cmH 2O. Conclusions Monitoring CVP was still an effective method directing fluid therapy in patients undergoing mechanical ventilation.