新医学Issue(4)：250-253,4.DOI:10.3969/g.issn.0253-9802.2015.04.010
ARDS 患者机械通气时不同呼气末正压对腹腔内压力的影响
Effect of different PEEP on intra-abdominal pressure in ARDS patients on mechanical ventilation
摘要
Abstract
Objective To observe the effect of different positive end-expiratory pressure (PEEP)on intra-abdominal pressure (IAP)in patients diagnosed with acute respiratory distress syndrome (ARDS)on me-chanical ventilation in a supine position.Methods A prospective self-control study consisting of 12 patients undergoing mechanical ventilation in intensive care unit (ICU)due to acute respiratory failure and subsequent-ly diagnosed with ARDS was performed.The variation of abdominal pressure was measured before mechanical ventilation and on mechanical ventilation with different PEEP (0,3,6,9,12 and 15 cm H2 O).Heart rate (HR),mean arterial pressure (MAP),oxygen saturation of pulse (SpO2 )and hourly urine volume were measured.Results IAP did not significantly differ over the sequential increase in PEEP from 0 to 9 cmH2 O (P >0.05).When PEEP was increased up to 12 and 15 cm H2 O,the IAP was significantly higher compared with those at 0 ~9 cm H2 O PEEP (all P <0.01 )and even reached grade II intra-abdominal hypertension.HR,MAP,SpO2 and hourly urine volume did not significantly differ under different PEEP conditions(all P >0.05).Conclusions During mechanical ventilation in a supine position,HR,MAP,SpO2 and hourly urine volume were not affected in a short period of time,whereas relatively high PEEP values (≥12 cm H2 O)could elevate IAP in ARDS patients on mechanical ventilation.IAP should be dynamically monitored to avoid a con-stant rise.关键词
呼气末正压/机械通气/急性呼吸窘迫综合征/腹腔内压力Key words
Positive end-expiratory pressure/Mechanical ventilation/Acute respiratory distress syndrome/Intra-abdominal pressure引用本文复制引用
谭华侨,胡浩荣,高东奔,李少明,裴华,邵超华..ARDS 患者机械通气时不同呼气末正压对腹腔内压力的影响[J].新医学,2015,(4):250-253,4.基金项目
东莞市科技计划医疗卫生类科研一般项目 （）
