健康麻醉犬压力控制通气与容积控制通气的心肺效果比较。

Denise T Fantoni, Keila K Ida, Thomas F T Lopes, Denise A Otsuki, José Otávio C Auler, Aline M Ambrósio
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引用次数: 15

摘要

目的:比较压力控制通气(PCV)和容量控制通气(VCV)对异氟醚麻醉犬肺顺应性、气体交换和血流动力学的影响。设计:前瞻性随机研究。单位:兽医教学医院。动物:40只客户拥有的母狗接受选择性卵巢子宫切除术。干预措施:狗被随机分配到使用PCV (n = 20)或VCV (n = 20)进行100%氧气通气。呼吸速率20次/min,呼气末正压(PEEP) 5 cm H2 O,潮气量10 mL/kg。心输出量(CO)采用热稀释法测定。自动通气时、控制通气30分钟(T30)和60分钟(T60)后的心肺和血气数据。测量结果及主要结果:PCV通气犬在T30和T60时,PIP低于VCV组(分别为11.4±1.9和11.1±1.5 cm H2 O),静态顺应性(CST)高于VCV组(PIP分别为14.3±1.3和15.5±1.4 cm H2 O)(分别为51±7和56±6 mL/cm H2 O);CST分别为34±8和33±9 mL/cm H2 O, P < 0.0001)。与自发通气相比,两组在T30和T60时肺泡-动脉氧差均降低(PCV分别为128±32 mm Hg vs 108±20和104±16 mm Hg;VCV分别为131±38 mm Hg vs 109±19和107±14 mm Hg;P < 0.01),而CO在各时间点均保持不变。结论:与自发通气相比,两种通气方式均能有效改善气体交换,且无血流动力学损伤。与VCV相比,PCV导致更高的肺CST和更低的PIP。
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A comparison of the cardiopulmonary effects of pressure controlled ventilation and volume controlled ventilation in healthy anesthetized dogs.

Objective: To compare the effects of pressure controlled ventilation (PCV) with volume-controlled ventilation (VCV) on lung compliance, gas exchange, and hemodynamics in isoflurane-anesthetized dogs.

Design: Prospective randomized study.

Setting: Veterinary teaching hospital.

Animals: Forty client-owned bitches undergoing elective ovariohysterectomy.

Interventions: Dogs were randomly assigned to be ventilated with 100% oxygen using PCV (n = 20) or VCV (n = 20). The respiratory rate was 20/min and positive end-expiratory pressure (PEEP) was 5 cm H2 O, with a tidal volume of 10 mL/kg. Cardiac output (CO) was measured using thermodilution. Cardiopulmonary and blood gas data were obtained during spontaneous ventilation and after 30 (T30) and 60 minutes (T60) of controlled ventilation.

Measurements and main results: In dogs ventilated with PCV, at T30 and T60, PIP was lower (11.4 ± 1.9 and 11.1 ± 1.5 cm H2 O, respectively) and static compliance (CST ) was higher (51 ± 7 and 56 ± 6 mL/cm H2 O, respectively) than in VCV group (PIP of 14.3 ± 1.3 and 15.5 ± 1.4 cm H2 O; CST of 34 ± 8 and 33 ± 9 mL/cm H2 O, P < 0.0001). Compared with spontaneous ventilation, both groups had decreased alveolar-arterial oxygen difference at T30 and T60 (PCV: 128 ± 32 mm Hg vs 108 ± 20 and 104 ± 16 mm Hg, respectively; VCV: 131 ± 38 mm Hg vs 109 ± 19 and 107 ± 14 mm Hg, respectively; P < 0.01), while CO was maintained at all time points.

Conclusions: Compared to spontaneous ventilation, both ventilatory modes effectively improved gas exchange without hemodynamic impairment. PCV resulted in higher lung CST and lower PIP compared to VCV.

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