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目的本文对８例危重症患者行Ａ／Ｃ、ＳＩＭＶ和ＰＳＶ呼吸支持，探讨三种方式对血液动力学和氧代谢的影响。方法呼吸支持最初阶段采用Ａ／Ｃ方式，并逐渐改为ＳＩＭＶ和ＰＳＶ方式，每种方式持续３０ｍｉｎ，ＳＩＭＶ频率为Ａ／Ｃ的７５％，ＰＳＶ设置在能够达到呼出气潮气量相同于Ａ／Ｃ的水平，三种方式吸入氧浓度不变，利用Ｓｗａｎ－Ｇａｎｚ导管获得血液动力学和氧代谢参数。结果与Ａ／Ｃ相比，ＳＩＭＶ和ＰＳＶ有一个低的ＰＩＰ增加的ＰａＯ２，与Ａ／Ｃ相比，ＳＩＭＶ可进一步增加ＣＩ和ＤＯ２、ＰｖＯ２。结论与Ａ／Ｃ相比，ＳＩＭＶ和ＰＳＶ对胸内压和血液动力学影响较小，ＳＩＭＶ可进一步增加组织的氧利用率。
OBJECTIVE: To investigate the effects of three modes on hemodynamics and oxygen metabolism in eight critically ill patients with A / C, SIMV and PSV respiratory support. Methods The initial stage of respiratory support was A / C mode, and gradually changed to SIMV and PSV mode, each mode lasts 30min, SIMV frequency is 75% of A / C, PSV is set to reach the same amount of exhaled air tidal volume as A / C The three inhaled oxygen concentrations were unchanged, and hemodynamic and oxygen metabolism parameters were obtained using a Swan-Ganz catheter. Results Compared with A / C, SIMV and PSV had a low PIP with increased PO2. Compared with A / C, SIMV could further increase CI and DO2, PvO2. Conclusions Compared with A / C, SIMV and PSV have little effect on intrathoracic pressure and hemodynamics, and SIMV can further increase tissue oxygen utilization.