O'Hare B, Chin C, Lerman J, Endo J
Department of Anaesthesia and the Research Institute, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
Anesthesiology. 1999 Apr;90(4):1112-8. doi: 10.1097/00000542-199904000-00026.
The authors compared the lung injury in rabbits that occurred after tracheal instillation of human breast milk (HBM) acidified to pH 1.8 with hydrochloric acid (HCl), HBM at its native pH (7.0), and HBM acidified with gastric juice to pH 1.8 and 3.0.
The alveolar-to-arterial oxygen tension gradient and dynamic compliance were recorded before and hourly for 4 h after intratracheal instillation of 0.8 ml/kg HBM acidified with HCI (pH 1.8), HBM at its native pH (7.0), HBM acidified with gastric juice (pH 1.8 or 3.0), or 5% dextrose solution acidified with gastric juice (pH 1.8) as a control in 30 adult rabbits. The circulating neutrophil count and phagocyte oxidant activity were determined before and 1 and 4 h after instillation.
The alveolar-to-arterial oxygen tension gradient increased and dynamic compliance decreased significantly in all groups after instillation of HBM compared with baseline values and those in the control group. The severity of the lung injury after instillation of HBM at all pH values (1.8, 3.0, and 7.0) and after acidification with gastric juice or HCl was similar. The circulating neutrophil count increased steadily for 4 h after instillation (P < 0.013), whereas spontaneous phagocyte oxidant burst activity peaked at 1 h (P < 0.007) and returned to baseline by 4 h after instillation.
The severity of the lung injury after tracheal instillation of 0.8 ml/kg HBM in rabbits is similar at pH values between 1.8 and 7.0 after acidification with HCl or gastric juice. Tracheal instillation of HBM increases the circulating neutrophil count and phagocyte oxidant burst activity.
作者比较了经气管内滴注用盐酸（HCl）酸化至pH 1.8的人母乳（HBM）、天然pH值（7.0）的HBM以及用胃液酸化至pH 1.8和3.0的HBM后家兔发生的肺损伤情况。
在30只成年家兔中，经气管内滴注0.8 ml/kg用HCl酸化（pH 1.8）的HBM、天然pH值（7.0）的HBM、用胃液酸化（pH 1.8或3.0）的HBM或用胃液酸化（pH 1.8）的5%葡萄糖溶液作为对照，在滴注前及滴注后每小时记录4小时的肺泡-动脉氧分压差和动态顺应性。在滴注前以及滴注后1小时和4小时测定循环中性粒细胞计数和吞噬细胞氧化活性。
与基线值和对照组相比，所有滴注HBM的组在滴注后肺泡-动脉氧分压差均显著增加，动态顺应性显著降低。在所有pH值（1.8、3.0和7.0）下滴注HBM后以及用胃液或HCl酸化后肺损伤的严重程度相似。滴注后循环中性粒细胞计数持续增加4小时（P<0.013），而自发吞噬细胞氧化爆发活性在1小时达到峰值（P<0.007），并在滴注后4小时恢复至基线水平。
在兔中经气管内滴注0.8 ml/kg HBM后，用HCl或胃液酸化至pH值在1.8至7.0之间时肺损伤的严重程度相似。经气管内滴注HBM可增加循环中性粒细胞计数和吞噬细胞氧化爆发活性。
