呼气末正压对中枢性呼吸衰竭患者中心静脉压和脉氧饱和度的影响

摘要

Objective To evaluate the impact of positive end - expiratory pressure (PEEP) on central venous pressure ( CVP) and saturation of pulse oxygen ( SpO2 ) in mechanically ventilated patients with central respiratory failure. Methods Thirty neurosurgical patients with central respiratory failure were enrolled in this prospective, interventional study. On admission to neurosurgical Intensive Care Unit, all the patients were ventilated in the mode of synchronized intermittent mandatory ventilation (SIMV). CVP and SpO2 were recorded and analyzed at six PEEP levels (0, 3, 6, 9, 12, 15 cm H2O, 1 cm H2O =0.098 kPa). Effects of different levels of PEEP on CVP and SpO2 were studied in all the patients of six groups. Results The values of CVP increased with increased PEEP. CVP values were positively correlated with the levels of PEEP (r =0.463, P =0. 000) , and the simple linear regression equation was: CVP(cm H20) = 7. 865 + 0. 359 x PEEP( cm H20) . The SpO2 showed no statistically significant difference at different PEEP levels(P >0. 05). Conclusion PEEP can increase CVP in the patients with central respiratory failure, but has no effect on SpO2.%目的 评估呼气末正压(PEEP)对中枢性呼吸衰竭患者中心静脉压(CVP)和脉氧饱和度(SpO2)的影响.方法 30例神经外科ICU中枢性呼吸衰竭患者均予同步间隙指令通气(SIMV),在不同PEEP水平(0、3、6、9、12、15 cm H2O)记录分析所有患者CVP和SpO2的变化,研究不同PEEP水平对重症患者CVP的影响.结果 CVP随PEEP水平的增加而增高,PEEP与CVP呈直线正相关(r=0.463,P=0.000),一元线性回归方程为:CVP (cm H2O)＝7.865+0.359×PEEP(cm H2O).在不同PEEP水平时SpO2比较差异无统计学意义(P>0.05).结论 PEEP可以增加中枢性呼吸衰竭患者CVP,而对SpO2无明显影响.