Effects Of Optimal PEEP On CVP In Mechanically Ventilated Patients With Pleural Effusion

Objective：To investigate Effects of optimal PEEP on CVP in mechanicallyventilated patients with pleural effusionMethods：Form2012.6-2014.3,in our hospital,28cases which wasmechanically ventilated were accepleted.We selected8levels of PEEPincluding0,2,4,6,9,12,15,18cmH2O.Each CVP has been received,and then investigate the relationship between PEEP and CVP.In allpatients,21cases were pleural effusion,the volum was from300ml-1500ml.There were7cases whth Non-pleural effusion in group A. Therewere12cases which volum from300ml-1000ml in group B,for group C,there were9cases which volum above1000ml.At last,we compare thedifference among the A、B、C group for CVP.Result：1. PEEP could affect the CVP. In either A, B or C group,the CVPincreased along with PEEP, there was positive correlation between theCVP and PEEP, with the correlation coefficients of0.705,0.695,0.742,respectively.2. PEEP affected the CVP differently. In group A, CVP was notsignificantly altered when the PEEP was2,4, and6cmH2O, but was statistically higher with PEEP of9、12、15、18cmH2O. In group B,similarly, only setting PEEP at9、12、15、18cmH2O achieved asignificantly elevated CVP. In group C, however, statastically increasedCVP could be seen when the PEEP was set at or above6cmH2O.Conclusions：1. Our observation after setting PEEP at several levels showed that,there was a positive correlation between PEEP and CVP, that is, when thePEEP was set, CVP could be elevated along with the PEEP.2. In patients with Non-pleural effusion and patients with pleuraleffusion less than1000ml, the PEEP affected the CVP similarly, that is,when PEEP was set at or above9cmH2O, the CVP could be furtherelevated.3. In patients with pleural effusion more than1000ml, however,PEEP at or above6cmH2O could achieve an elevated CVP, different tothe above cases.4. For patients who need mechanical ventilation and suffer pleuraleffusion at the same time, with different PEEP setting, when using CVPas guidance for the effective circulating blood volume, cardiac functionand rehydration, a high volume of pleural effusion could be anindependent factor.