机械通气患者不同呼气末正压及体位对中心静脉压的影响

张晶, 柳莹, 刘莉莉, 张蒙

张晶, 柳莹, 刘莉莉, 张蒙. 机械通气患者不同呼气末正压及体位对中心静脉压的影响[J]. 实用临床医药杂志, 2017, (4): 47-49. DOI: 10.7619/jcmp.201704015
引用本文: 张晶, 柳莹, 刘莉莉, 张蒙. 机械通气患者不同呼气末正压及体位对中心静脉压的影响[J]. 实用临床医药杂志, 2017, (4): 47-49. DOI: 10.7619/jcmp.201704015
ZHANG Jing, LIU Ying, LIU Lili, ZHANG Meng. Influence of different positive end-expiratory pressure and postures on central venous pressure of patients with mechanical ventilation[J]. Journal of Clinical Medicine in Practice, 2017, (4): 47-49. DOI: 10.7619/jcmp.201704015
Citation: ZHANG Jing, LIU Ying, LIU Lili, ZHANG Meng. Influence of different positive end-expiratory pressure and postures on central venous pressure of patients with mechanical ventilation[J]. Journal of Clinical Medicine in Practice, 2017, (4): 47-49. DOI: 10.7619/jcmp.201704015

机械通气患者不同呼气末正压及体位对中心静脉压的影响

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  • 中图分类号: R473.5

Influence of different positive end-expiratory pressure and postures on central venous pressure of patients with mechanical ventilation

  • 摘要: 目的 探讨机械通气患者不同呼气末正压(PEEP)及体位对中心静脉压(CvP)的影响.方法 选取因呼吸衰竭行机械通气患者48例,检测PEEP为0、3、6、9、12、15及18 emH2O时的CVP值以及患者取平卧位、平卧位下床头抬高15°、30°、45°及60°卧位时的CVP值.结果 CVP值随PEEP水平的升高而升高,且PEEP≥15 emH2O时的水平明显高于在0~12 cmH2O时的测量值(P<0.05或P<0.01);不同PEEP对心率(HR)和平均动脉压(MAP)的影响不明显(P>0.05),血氧饱和度(SpO2)随着PEEP升高而升高,当PEEP≥12 cmH2O时,SpO2升高更明显,与PEEP≤6 cmH2O时比较差异显著(P<0.01).平卧位时CVP值高于平卧位下床头抬高15°、30°、45°、60°卧位的CVP值(P<0.05或<0.01),且卧位角度越大,CVP值越小;不同体位对HR、MAP及SpO2水平几乎无影响(P>0.05).结论 不同PEEP和体位均影响CVP值,危重患者测量CVP时尽量保持原体位.
    Abstract: Objective To explore the influence of different positive end-expiratory pressure (PEEP) and postures on central venous pressure (CVP) of patients with mechanical ventilation.Methods A total of 48 patients with mechanical ventilation due to respiratory failure were selected.CVP values when PEEP was at 0,3,6,9,12,15 and 18 cm H2O and the values when patients were placed in supine position or when bedside was lifted by 15°,30°,45°and 60°in supine position were detected.Results CVP value increased with the increase of PEEP level,and it was markedly higher when PEEP≥15 cmH2O than that when PEEP was 0 ~ 12 cmH2O (P <0.05 or P <0.01).Different PEEP had insignificant influence on heart rate (HR) and mean arterial pressure (MAP) (P > 0.05).However,saturation of blood oxygen (SpO2) increased with the increase of PEEP level,which increased more significantly when PEEP ≥ 12 cmH2O than that when PEEP ≤6 cmH2O (P < 0.01).CVP value was markedly higher in supine position than that when bedside was lifted by 15°,30°,45°and 60°(P <0.05 or P <0.01).The larger the angle of supine position was,and lower the CVP value became.And different postures had no influence on levels of HR,MAP and SpO2 (P > 0.05).Conclusion Different PEEP and postures have great influence on CVP values,and severe patients should be placed in original position when detecting CVP.
  • 期刊类型引用(8)

    1. 刘洁霞,宋向阳. 手工测量法与压力传感器测量法在中心静脉压监测中的效果比较. 当代护士(中旬刊). 2021(01): 113-114 . 百度学术
    2. 陆莉金. 中心静脉压测量方法及其临床研究进展. 微创医学. 2021(01): 112-114 . 百度学术
    3. 付艳芳. 不同呼气末正压机械通气及不同体位对呼吸衰竭患者中心静脉压的影响研究. 临床研究. 2021(06): 160-161 . 百度学术
    4. 曹鹏,宋正杰,程静林. 驱动压导向的个体化呼气末正压通气对腹腔镜手术患者的肺保护作用. 实用临床医药杂志. 2021(10): 40-44 . 本站查看
    5. 李梦媛. 不同俯卧位角度机械通气对实施床旁血滤急性呼吸窘迫综合征患儿的影响. 中国医学工程. 2020(03): 33-36 . 百度学术
    6. 赵明曦,郭海凌,何怀武,李奇,李尊柱,孙建华,李真,孙红. ICU医护人员中心静脉压测量流程及临床应用现状调查. 护理学杂志. 2020(21): 66-69 . 百度学术
    7. 祁涛,沙欢欢,陈静,朱昌茂,潘熊熊. 呼气末正压通气对腹腔镜肝切除手术患者中心静脉压及术中出血的影响. 海南医学院学报. 2020(23): 1788-1792 . 百度学术
    8. 周伟. 严重肺部感染机械通气患者床头抬高不同角度对中心静脉压的影响. 中西医结合心血管病电子杂志. 2017(29): 16-17 . 百度学术

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