REEVALUATION OF HEMODYNAMIC CONSEQUENCES OF POSITIVE PRESSURE VENTILATION - EMPHASIS ON CYCLIC RIGHT VENTRICULAR AFTERLOADING BY MECHANICAL LUNG-INFLATION
REEVALUATION OF HEMODYNAMIC CONSEQUENCES OF POSITIVE PRESSURE VENTILATION - EMPHASIS ON CYCLIC RIGHT VENTRICULAR AFTERLOADING BY MECHANICAL LUNG-INFLATION
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DOI：
10.1097/00000542-199006000-00003
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发表时间：
1990-06-01
期刊：
影响因子：
8.8
通讯作者：
BOURDARIAS, JP
中科院分区：
文献类型：
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作者：
JARDIN, F;DELORME, G;BOURDARIAS, JP
为了检查控制性通气引起的右心室（RV）功能的周期性变化，对20例急性呼吸衰竭发作需要呼吸支持的患者进行了右心导管插入术和二维超声心动图检查。同时测量右心室压力（使用改良的肺动脉导管）、右心室每搏输出量（热稀释法）和右心室尺寸（二维超声心动图），可以在整个机械呼吸周期中逐搏评价右心室功能。与呼气相比，肺充气使RV收缩压和容积增加，RV舒张压不变的情况下RV舒张容积增加，RV射血分数显著降低。可以得出结论，控制通气改变RV功能主要是通过增加RV后负荷在肺膨胀期间。
To examine the cyclic changes in right ventricular (RV) function induced by controlled ventilation, right heart catheterization and two-dimensional echocardiography were combined in a group of 20 patients requiring respiratory support for an episode of acute respiratory failure. Simultaneous measurements of RV pressure (using a modified pulmonary artery cetheter), RV stroke output (thermodilution), and RV dimensions (two-dimensional echocardiography), permitted a beat to beat evaluation of RV function throughout the mechanical respiratory cycle. When compared with expiration, lung inflation produced an increase in RV systolic pressure and volume, an increase in RV diastolic volume with an unchanged RV diastolic pressure, and a marked decrease in RV ejection fraction. It is concluded that controlled ventilation altered RV function primarily by increasing RV afterload during the lung inflation period.