Doctor A, Mazzoni M C, DelBalzo U, DiCanzio J, Arnold J H
Department of Anesthesia, Children's Hospital and Harvard Medical School, Boston, MA, USA.
Crit Care Med. 1999 Nov;27(11):2500-7. doi: 10.1097/00003246-199911000-00029.
To examine the efficiency of gas exchange, hemodynamic function, and histopathologic evidence of lung protection using high-frequency oscillation of the perfluorocarbon-filled lung in a model of acute lung injury.
An animal research laboratory.
A prospective, randomized animal study comparing animals randomized to high-frequency oscillation or high-frequency oscillation and perfluorocarbon administration (perfluoro-octyl bromide, perfubron, or LiquiVent).
Ten healthy swine (mean weight, 24.6 kg) with saline lavage-induced acute lung injury.
Animals were treated with repetitive saline lavage to achieve a uniform degree of acute lung injury (Pao2 of <90 torr [11.9 kPa] on a Fio2 of 1.0). After lung injury, subjects were changed to high-frequency oscillatory ventilation and stabilized for 1 hr. High-frequency oscillation of the perfiuorocarbon-filled lung was initiated in five animals with the instillation of 30 mUkg perflubron and five animals continued receiving high-frequency oscillation for a total duration of 2 hrs after the dosing period. Histopathologic evidence of lung injury was quantified by a pathologist using an eight-variable lung injury scoring system to generate a lung injury score.
Administration of perflubron did not produce acute alterations of gas exchange. After the dosing period, there were no differences in gas exchange, hemodynamic function, or pulmonary vascular resistance between the two groups. The perfluorocarbon-treated animals had a significantly lower histopathologic total lung injury score, primarily manifested by significantly less atelectasis.
The combination of high-frequency oscillatory ventilation and partial liquid ventilation with perfiubron was well tolerated hemodynamically, was not associated with deterioration of gas exchange during dosing, and did not produce significant differences in either gas exchange or hemodynamic variables over a 2-hr period. There was histopathologic evidence that the combination of high-frequency oscillation and perfiubron administration produces improved recruitment in both dependent and nondependent lung regions.
在急性肺损伤模型中，研究使用全氟化碳填充肺进行高频振荡时的气体交换效率、血流动力学功能及肺保护的组织病理学证据。
动物研究实验室。
一项前瞻性、随机动物研究，比较随机分为高频振荡组或高频振荡加全氟化碳给药组（全氟辛基溴、全氟溴烷或LiquiVent）的动物。
十只经盐水灌洗诱导急性肺损伤的健康猪（平均体重24.6千克）。
对动物进行反复盐水灌洗，以达到均匀程度的急性肺损伤（吸入氧分数为1.0时动脉血氧分压<90托[11.9千帕]）。肺损伤后，将受试者改为高频振荡通气并稳定1小时。五只动物通过注入30毫升/千克全氟溴烷开始对全氟化碳填充肺进行高频振荡，另外五只动物在给药期后继续接受高频振荡，持续2小时。病理学家使用八变量肺损伤评分系统对肺损伤的组织病理学证据进行量化，以得出肺损伤评分。
全氟溴烷给药未引起气体交换的急性改变。给药期后，两组之间在气体交换、血流动力学功能或肺血管阻力方面无差异。全氟化碳治疗的动物组织病理学总肺损伤评分显著较低，主要表现为肺不张明显减轻。
高频振荡通气与全氟溴烷部分液体通气相结合在血流动力学上耐受性良好，给药期间未伴有气体交换恶化，且在2小时内气体交换或血流动力学变量均未产生显著差异。有组织病理学证据表明，高频振荡与全氟溴烷给药相结合可改善依赖和非依赖肺区域的肺复张。
