体位 脱机及不同peep对机械通气患者cvp的影响-influence of off-line posture and different peep on cvp in patients with mechanical ventilation.docxVIP

II II Abstract Object: To investigate the effect of posture,detaching ventilation and different positive end expiratory pressure on central venous pressure in patients undergoing mechanical ventilation. Methods: In a prospective self-controlled research, 33 patients who puted subclavian vein vasacular and undergone mechanical ventilation were enrolled. At first, Central venous pressure（CVP）,hearth rate(HR),mean arterial pressure(MAP),oxygen saturation of pulse(SpO2) were measured with a supine flat position ,and with different positive end expiratory pressure (0cmH20、5cmH20、10cmH20、15cmH20), detaching ventilation and undergoing mechanical ventilation. PEEP increased 5cmH20 each time from 0cmH20 to 15cmH20.Then, the parameters were measured with a supine flat position at different mechanical ventilation, positive end expiratory pressure (0 cmH20、5cmH20、10cmH20、15cmH20), after 30 minute ,the patients were in quite, CVP，HR，MAP，SpO2 were measured again with a backrest elevation of 45°. Results:There were no significant differences in the measurements between the different postures,it included CVP，HR，MAP，SpO2. （P0.05）, CVP increased gradually by the increment of PEEP. There were no significant differences in the measurements between 0cmH2O PEEP and 5cmH2O PEEP. There were no significant differences in the measurements when detaching ventilation, CVP，HR，MAP， SpO2were measured in no differences. There were significant differences in the measurements between different mechanical ventilation conditions. ( before detaching ventilation, detaching ventilation, after detaching ventilation) Conclusion: There were no significant effect of posture on central venous pressure in patients undergoing mechanical ventilation. CVP increased gradually with the increment of PEEP, there are no different when PEEP ≤5cmH2O. Detaching ventilator led to the decreased of SpO2. It suggested that the rule posture of patients undergoing mechanical ventilation were the semireclining position. Central