摘要
目的 :评估吸入低浓度一氧化氮 (NO)治疗感染性休克并发急性呼吸窘迫综合征 (ARDS)患者的有效性及对患者血流动力学的影响。方法 :对 17例感染性休克并发 ARDS患者行机械通气 ,Swan Ganz导管检查 ,观察吸入 10 m mol/ L NO前后氧合功能和血流动力学的变化。结果 :吸入 NO后 ,患者动脉血氧分压、血氧饱和度及氧合指数分别由 (8.6 7± 2 .15 ) k Pa(1k Pa=7.5 mm Hg) ,0 .86± 0 .0 8和 (9.6 3± 3.0 7) k Pa上升至(17.74± 8.82 ) k Pa,0 .95± 0 .0 8和 (2 5 .33± 11.36 ) k Pa(P均 <0 .0 0 1) ;肺内分流率由 (4 7.4± 13.3) %下降至(2 8.1± 12 .7) % (P<0 .0 0 1) ;血流动力学参数 :平均动脉压、平均肺动脉压、心输出量、心脏指数、体肺循环阻力指数、中心静脉压及肺动脉楔压均无明显变化 (P均 >0 .0 5 )。结论 :吸入低浓度 NO对感染性休克并发ARDS患者的氧合功能、血气指标有明显改善且血流动力学稳定 。
Objective:To assess the therapeutic effects of nitric oxide(NO) inhalation on septic shock complicated with acute respiratory distress syndrome (ARDS) and its impact on hemodynamics.Methods:Seventeen patients with septic shock complicated with ARDS underwent mechanical ventilation and SwanGanz catheterization.Hemodynamic parameters were monitored and blood gas analysis was performed before and after inhalation of 10 mmol/L NO.Results:After NO inhalation,PaO 2,arterial oxygen saturation(SaO 2) and PaO 2/FiO 2 increased from (8 67±2 15)kPa (1 kPa=7 5 mmHg),0 86±0 08 and (9 63±3 07)kPa to (17 74±8 82)kPa,0 95±0 08 and (25 33±11 36)kPa respectively (all P<0 001).Intrapulmonary shunt ratio(s/t) significantly decreased from (47 4±13 3)% to (28 1±12 7)%(P<0 001).Hemodynamic parameters (MBP,MPAP,CO,CI,CVP,PAWP,SVRI,PVRI) showed no significant changes before and after NO inhalation (all P>0 05).Conclusions:Low dose NO inhalation is effective and safe in the treatment of septic shock complicated with ARDS.
出处
《中国危重病急救医学》
CSCD
2000年第9期549-551,共3页
Chinese Critical Care Medicine
关键词
呼吸窘迫综合征
感染性休克
一氧化氮
氧合功能
acute respiratory distress syndrome
septic shock
nitric oxide
oxygenation
hemodynamics
