Liu J M, Evander E, Zhao J, Wollmer P, Jonson B
Department of Clinical Physiology, University Hospital of Lund, Lund, Sweden.
Clin Physiol. 2001 Jul;21(4):421-7. doi: 10.1046/j.1365-2281.2001.00348.x.
Detergent given as an aerosol and large tidal volume ventilation (LTVV) have been observed, by us, to promote lung injury by an additive effect on alveolocapillary barrier function. The surfactant system may be further damaged if protein leakage occurs into the alveoli. The aim was to study the effect of detergent and LTVV on the alveolar leakage of albumin and also the effect of detergent on surface activity of lung washings and lung tissue extracts. Technetium-99m-labelled human serum albumin was given intravenously. The alveolar leakage of albumin was measured after perturbing the surfactant system with the detergent dioctyl sodium sulfosuccinate either singly or in combination with LTVV. Four groups of rabbits were studied after 3 h of experimental ventilation. Surface tension measurements of tissue extracts, lung mechanics and gas exchange did not show any differences between groups. Wet lung weight and albumin leakage were significantly increased in the two groups subjected to LTVV compared with groups given normal tidal volume ventilation. Low doses of detergent did not affect surface activity of lung tissue extracts or alveolar leakage of albumin. LTVV increased alveolar leakage of albumin and produced oedema. No additive effect was seen when detergent and LTVV were combined.
我们观察到，以气雾剂形式给予去污剂并进行大潮气量通气（LTVV），会通过对肺泡毛细血管屏障功能产生累加效应来促进肺损伤。如果蛋白质漏入肺泡，表面活性剂系统可能会进一步受损。目的是研究去污剂和LTVV对白蛋白肺泡渗漏的影响，以及去污剂对肺灌洗物和肺组织提取物表面活性的影响。静脉注射锝-99m标记的人血清白蛋白。在用去污剂二辛基磺基琥珀酸钠单独或与LTVV联合扰动表面活性剂系统后，测量白蛋白的肺泡渗漏。在实验通气3小时后，对四组兔子进行了研究。组织提取物的表面张力测量、肺力学和气体交换在各组之间未显示任何差异。与给予正常潮气量通气的组相比，接受LTVV的两组湿肺重量和白蛋白渗漏显著增加。低剂量的去污剂不影响肺组织提取物的表面活性或白蛋白的肺泡渗漏。LTVV增加了白蛋白的肺泡渗漏并产生了水肿。当去污剂和LTVV联合使用时，未观察到累加效应。
