气管内吹气在急性呼吸窘迫综合征患者中的应用

摘要

Objective To evaluale ihe effecls of Lracheal gas insufflalion in adull wilh acule respiralory dislress syndrome who were ulilize low lidal volume and approach mechanism. Methods ARDS wilh permissive hypercapnia were assigned Lo TGI ( continuous TGI flow al a rale 2 L/min was introduce ) for 2 hour. Values of arterial blood gas analysis, PIP, Plal, PEEP, Heart rale, mean arterial blood pressure were recorded every 30 min. Results TGI resulled decrease in PaCO2, respective as compared wilh baseline, furthermore 120 min group difference was slalislical significance. Conclusion Homemade Lracheal venlilalion device Lo implemenL TGI can improve PHC, reducing support condiLions of venLilaLor.%目的 观察在小潮气量机械通气基础上应用气管内吹气(tracheal gas insufflation,TGI)对实施允许性高碳酸血症(PHC)的急性呼吸窘迫综合征(ARDS)患者的疗效,并探讨其机制.方法 对我院两年来诊断明确的ARDS患者在小潮气量机械通气、PHC基础上应用我院自行设计的气管内吹气装置持续TGI,低流量(2 L/min)吹入新鲜气体治疗2 h,每30min记录动脉血气(PaCO2、PaO2)、潮气量、血氧饱和度(SaO2)、吸气峰压(PIP)、平台压(Plat)、呼气末正压(PEEP)、心率和平均动脉压(MAP).结果 在各时间段气管内吹气后PaCO2较吹气前下降,120 min 组差异有统计学意义.结论 应用自行设计的气管内通气装置在ARDS患者中短期实施气管内吹气,可以改善PHC,降低呼吸机的支持条件.