Harrington D T, Jordan B S, Dubick M A, Cancio L C, Brinkley W, Kim S, Burleson D G, Delgado A, Goodwin C W
United States Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA.
J Appl Physiol (1985). 2001 Jun;90(6):2351-60. doi: 10.1152/jappl.2001.90.6.2351.
In an earlier neonatal porcine model of smoke inhalation injury (SII), immediate postinjury application of partial liquid ventilation (PLV) had dramatic beneficial effects on lung compliance, oxygenation, and survival over a 24-h period. To explore the efficacy of PLV following SII, we treated animals at 2 and 6 h after SII and followed them for 72 h. Pigs weighing 8-12 kg were sedated and pharmacologically paralyzed, given a SII, and placed on volume-cycled, pressure-limited ventilation. Animals were randomized to three groups: group I (+SII, no PLV, n = 8), group II (+SII, PLV at 2 h, n = 6), and group III (+SII, PLV at 6 h, n = 7). Ventilatory parameters and arterial blood gasses were obtained at scheduled intervals. The PLV animals (groups II and III) followed a worse course than group I (no PLV); PLV groups had higher peak and mean airway pressures, oxygenation index, and rate-pressure product (a barotrauma index) and lower lung compliance and arterial partial pressure of oxygen-to-inspired oxygen fraction ratio (all P < 0.05). PLV conferred no survival advantage. The reported beneficial effects of PLV with other models of acute lung injury do not appear to extend to the treatment of SII when PLV is instituted in a delayed manner. This study was not able to validate the previously reported beneficial effects of PLV in SII and actually found deleterious effects, perhaps reflecting the predominance of airway over alveolar disease in SII.
在早期的新生儿猪烟雾吸入性损伤（SII）模型中，损伤后立即应用部分液体通气（PLV）在24小时内对肺顺应性、氧合和存活率具有显著的有益影响。为了探究SII后PLV的疗效，我们在SII后2小时和6小时对动物进行治疗，并对它们进行72小时的跟踪观察。将体重8 - 12千克的猪进行镇静和药物麻痹，使其遭受SII，然后置于容量控制、压力限制通气模式下。动物被随机分为三组：第一组（+SII，未进行PLV，n = 8），第二组（+SII，在2小时时进行PLV，n = 6），第三组（+SII，在6小时时进行PLV，n = 7）。按预定时间间隔获取通气参数和动脉血气。接受PLV的动物（第二组和第三组）的病情发展比第一组（未进行PLV）更差；PLV组的气道峰压和平均压、氧合指数以及速率 - 压力乘积（气压伤指数）更高，而肺顺应性和动脉血氧分压与吸入氧分数之比更低（所有P < 0.05）。PLV未带来生存优势。当延迟应用PLV时，PLV在其他急性肺损伤模型中所报道的有益效果似乎并未延伸至SII的治疗。本研究未能证实先前报道的PLV在SII中的有益效果，实际上发现了有害影响，这可能反映了SII中气道疾病比肺泡疾病更为突出。
