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首页> 外文期刊>Journal of cardiac failure >Enhancement of cardiac performance by bilevel positive airway pressure ventilation in heart failure
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Enhancement of cardiac performance by bilevel positive airway pressure ventilation in heart failure

机译：心力衰竭中双水平气道正压通气增强心脏功能

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Background: Recent studies have reported the clinical usefulness of positive airway pressure ventilation therapy with various kinds of pressure support compared with simple continuous positive airway pressure (CPAP) for heart failure patients. However, the mechanism of the favorable effect of CPAP with pressure support can not be explained simply from the mechanical aspect and remains to be elucidated. Methods and Results: In 18 stable chronic heart failure patients, we performed stepwise CPAP (4, 8, 12 cm H2O) while the cardiac output and intracardiac pressures were continuously monitored, and we compared the effects of 4 cm H2O CPAP with those of 4 cm H 2O CPAP plus 5 cm H2O pressure support. Stepwise CPAP decreased cardiac index significantly in patients with pulmonary arterial wedge pressure (PAWP) 12 mm Hg (n = 10), but not in those with PAWP ≥12 mm Hg (n = 8). Ventilation with CPAP plus pressure support increased cardiac index slightly but significantly from 2.2 ± 0.7 to 2.3 ± 0.7 L min -1 m-2 (P =.001) compared with CPAP alone, regardless of basal filling condition or cardiac index. Conclusions: Our results suggest that CPAP plus pressure support is more effective than simple CPAP in heart failure patients and that the enhancement might be induced by neural changes and not simply by alteration of the preload level.
机译：背景：最近的研究报道，与单纯持续气道正压通气（CPAP）相比，采用各种压力支持的气道正压通气治疗对心力衰竭患者的临床有效性。然而，不能简单地从机械方面解释CPAP在压力支持下的有益作用的机理，还有待阐明。方法和结果：在18例稳定的慢性心力衰竭患者中，我们连续进行CPAP（4、8、12 cm H2O），同时连续监测心输出量和心内压，并将4 cm H2O CPAP与4 cm H2O CPAP的效果进行比较cm H 2O CPAP加上5 cm H2O压力支撑。在肺动脉楔压（PAWP）<12 mm Hg（n = 10）的患者中，逐步CPAP可以显着降低心脏指数，但在PAWP≥12mm Hg（n = 8）的患者中，CPAP不能显着降低心脏指数。与单独的CPAP相比，CPAP加压力支持的通气使心脏指数略有增加，但从2.2±0.7升至2.3±0.7 L min -1 m-2（P = .001）显着增加，无论基础充盈情况或心脏指数如何。结论：我们的结果表明，在心力衰竭患者中，CPAP加压力支持比简单的CPAP更有效，并且这种增强可能是由神经变化而不是简单地通过改变预负荷水平引起的。

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