心肺复苏时呼吸机高压报警上限与吸气触发灵敏度合理设置的临床研究*

Study on reasonable setting of upper limit of high pressure alarm and inspiration trigger sensitivity of ventilator during cardiopulmonary resuscitation*

摘要:

目的 观察心肺复苏时呼吸机不同高压报警上限和吸气触发灵敏度设置对复苏效果的影响，探讨心 肺复苏时合理的高压报警上限和吸气触发灵敏度设置，提高心肺复苏效果。方法 选取2015年12月—2018年 12月绍兴市人民医院收治的53例心肺复苏患者，采用随机数字表法分为A组27例和B组26例。A组高压报警上限 设置为80 cmH2O，吸气触发灵敏度选择压力触发-20 cmH2O；B组按常规设置，高压报警上限设置为35 cmH2O， 吸气触发灵敏度选择流量触发3。监测两组2 min、10 min、20 min、30 min时呼出潮气量、呼吸频率、呼气末二 氧化碳分压（PETCO2）及动脉血氧分压（PaO2），并比较两组复苏成功率。结果 A组不同时间点呼出潮气量、 PETCO2、PaO2高于B组（P <0.05）；而各时间点呼吸频率低于B组（P <0.05）。A组30 min时复苏成功率高于B组（P < 0.05）。结论 高压报警上限设置为80 cmH2O，触发选择压力触发-20 cmH2O可提高心肺复苏的疗效。

Abstract:

Objective To observe the effect of mechanical ventilation with different upper limit of high pressure alarm and inspiratory trigger sensitivity on cardiopulmonary resuscitation (CPR), to explore the reasonable setting of upper limit of high pressure alarm and sensitivity of inspiratory trigger during cardiopulmonary resuscitation, and to improve the recovery effect of CPR. Methods From December 2015 to 2018, 53 cases of cardiopulmonary resuscitation patients in our hospital were randomly and evenly divided into group A and group B. 80 cmH2O of the upper limit of the high pressure alarm and -20 cmH2O of inspiratory trigger sensitivity was applied to patients of group A. Group B using conventional settings, the upper limit of the high pressure alarm with 35 mH2O and inspiratory trigger sensitivity with flow trigger 3. Expiratory tidal volume (VTe), respiratory rate (f), idal carbon dioxide (PETCO2), arterial partial pressure of oxygen (PaO2) at 2, 10, 20 and 30 min in two groups were observed and recorded. Meanwhile, the success rate of recovery were compared between the two groups. Results Compared with the mean relative tidal volume, mPETCO2, and mPaCO2 at each time points, group A was higher than group B (P < 0.05); the mean respiratory rate at each time points in group A was lower than in group B (P < 0.05); at 30 min, the success rate of resuscitation in group A (51.9%) was higher than that in group B (23.1%) (P < 0.05). Conclusion The upper limit of the high pressure alarm with 80 cmH2O and sensitivity of inspiratory trigger with - 20 mH2O can improve the recovery effect of CPR.