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目的探讨呼气末正压（ＰＥＥＰ）通气对急性呼吸衰竭病人全身氧供给（ＤＯ２）的影响。方法选择２０例急性呼吸衰竭机械通气病人，放置Ｓｗａｎ－Ｇａｎｚ导管，依次调节ＰＥＥＰ为０、０４９ｋＰａ、０９８ｋＰａ、１４７ｋＰａ四种压力水平，分别测定气体交换功能及氧动力学指标。结果ＰＥＥＰ为０４８ｋＰａ时动脉血氧分压（ＰａＯ２）即开始明显升高（Ｐ＜０５），心脏指数（ＣＩ）却出现降低（Ｐ＜００５），随着ＰＥＥＰ增加，ＣＩ逐渐下降。ＤＯ２在ＰＥＥＰ为０９８ｋＰａ以下时变化不显著，在１４７ｋＰａ时出现显著下降（Ｐ＜００５），而氧摄取率（ＥｘｔＯ２）则有所增加（Ｐ＜００５）。结论ＰＥＥＰ使用不能明显提高ＤＯ２，高水平的ＰＥＥＰ可以降低ＤＯ２，必须采取措施提高ＣＩ才能使ＤＯ２增加。
Objective To investigate the effect of positive end-expiratory pressure (PEEP) ventilation on systemic oxygen supply (DO2) in patients with acute respiratory failure. Methods Twenty patients with mechanical ventilation of acute respiratory failure were enrolled in this study. Swan-Ganz catheter was placed. The four PEEP pressure levels were 0, 049 kPa, 098 kPa and 147 kPa. The gas exchange function and oxygenation index were measured respectively. Results When the PEEP was 048 kPa, the PaO2 began to increase (P <05) and the CI decreased (P <005). With the increase of PEEP, CI decreasing gradually. DO2 did not change significantly under PEEP of 098kPa, but decreased significantly at 147kPa (P <005), while ExtO2 increased (P <005). Conclusions The use of PEEP can not improve DO2 significantly. High levels of PEEP can reduce DO2, and measures must be taken to increase CI in order to increase DO2.