论文部分内容阅读
目的 探讨允许性高碳酸血症 (PHC)对ARDS肺外器官功能的影响。方法 观察不同潮气量 (VT)时 ,18只ARDS绵羊血液动力学、氧代谢和胃粘膜pH(pHi)的改变。结果 当VT从 16ml/kg降至 4～ 7ml/kg时 ,绵羊均出现PHC ;与VT13～ 16ml/kg比较 ,PHC时心排指数 (CI)显著降低 (P <0 0 5 ) ) ,体循环和肺循环阻力指数显著增高 (P <0 0 5 ) ) ,尽管PHC时动脉血氧分压及氧饱和度、混合静脉血氧饱和度和氧输送显著降低 (P <0 0 5 ) ) ,但氧耗和肺内分流率无明显变化 ,组织无氧债 ,pHi无明显改变 (P >0 0 5 ) )。结论 实施PHC时 ,虽然CI降低 ,低氧血症加重 ,但并不加重组织缺氧。
Objective To investigate the effect of permissive hypercapnia (PHC) on the extra-pulmonary organ function of ARDS. Methods The changes of hemodynamics, oxygen metabolism and gastric mucosal pH (pHi) were observed in 18 ARDS sheep at different tidal volumes (VT). Results When the VT was reduced from 16ml / kg to 4 ~ 7ml / kg, the PHC appeared in sheep. Compared with VT13 ~ 16ml / kg, the CI decreased significantly (P <0.05) Pulmonary circulation resistance index was significantly higher (P <0.05)). Although arterial oxygen tension and oxygen saturation, mixed venous oxygen saturation and oxygen delivery were significantly decreased at PHC (P <0.05), the oxygen consumption And pulmonary shunt rate no significant change in tissue oxygen-free debt, pHi no significant change (P> 0.05)). Conclusions Although PH is decreased and hypoxemia aggravates when implementing PHC, it does not aggravate hypoxia.