机械通气是心肺复苏(CPR)过程中替代人工通气的有效手段,已广泛应用于心搏骤停(CA)患者的救治中.然而,目前对于复苏过程中机械通气有效性的评估,通气过程中的最佳吸入氧浓度(FiO2)、潮气量(VT)、通气频率以及通气模式等参数的设置仍存在争议,对于正压通气的利弊也尚无定论.通过回顾和总结近年来相关研究,推荐CPR过程中机械通气可暂时采用容量控制间歇正压通气(IPPV)模式,选择小VT(6~7 mL/kg)、低频率(10次/min)以及纯氧通气.而在CPR过程中最佳的机械通气策略尚需进一步研究探索和发掘.
Mechanical ventilation is regarded as an effective means of replacing artificial ventilation during cardiopulmonary resuscitation (CPR), and has been widely used in the treatment of cardiac arrest (CA) patients. However, there are still some controversial issues remaining to be settled, such as the assessmentof the effectiveness of mechanical ventilation, the selection of the optimal oxygen concentration (FiO2), tidal volume (VT), respiratory frequency, and mode of ventilation during the CPR process. The pros and cons of positive pressure ventilation are also inconclusive. We reviewed and summarized the related research in recent years, and recommended that the intermittent positive pressure ventilation (IPPV) of volume controlled with small VT (6-7 mL/kg), low ventilation rates (10 times/min), and pure oxygen could be applied during the mechanical ventilation of CPR. The best mechanical ventilation strategy still needs further experimental researches to discover and explore.