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控制通气频率和潮气量变化的影响:在犬动脉血二氧化碳分压恒定情况下的测量

Effects of changes of frequency and tidal volume of controlled ventilation: measurements at constant arterial Pco2 in dogs.

作者信息

Lunn J N, Mapleson W W, Chilcoat R T

出版信息

Br J Anaesth. 1975 Jan;47(1):2-16. doi: 10.1093/bja/47.1.2.

Abstract

Seven Alsatian dogs were anaesthetized with thiopentone, paralysed with pancuronium, and ventilated with 1% halothane in a mixture of air and oxygen in such a way as to maintain Paco2 at 40 mm Hg and Pao2 at 150 mm Hg. From various respiratory and circulatory measurementts the following variables were determined: physiologicaldeadspace, cardiac output, venous admixture, respiratory compliance and resistance, and oxygen and carbondioxide exchcnage. After a controlseries of measurements at a ventilator frequency of was doubled to 50/min and adjustments to tidal volume and inspired oxygen concentration made to maintain constancy of blood gas tensions. The same procedure was followed again at 25/min, l/min and finally at 25/min. At each frequency the I:E ratio was kept at 1/2, the shape of the inspiratory flow waveform was kept constant (a rapid increase followed by a steady decline to zero) and expiration was passive to atmosphere. Mean results showed that physiological deadspace changed relatively little with frequency so that the deadspace:tidal volume ratio increased significantly on changing to 50/min (by 24%) and decreased significantly on changing to 6/min (by 46%). Changes of cardiac output and venous admixture were either not significant or on the borderline of significance and the 95% confidence limits of these changes were within +14%, --12% for cardiac outpur and within plus or minus1.4% of cardiac output for venous admixture. Tt is concluded that, provided Paco2 and Pa02 and mean air way pressure are kept constant, the frequency of ventilation is not important, even over a wide range of values.

摘要

七只阿尔萨斯犬用硫喷妥钠麻醉,用泮库溴铵使其麻痹,并用含1%氟烷的空气和氧气混合物进行通气,以使动脉血二氧化碳分压(Paco2)维持在40 mmHg,动脉血氧分压(Pao2)维持在150 mmHg。通过各种呼吸和循环测量确定了以下变量:生理死腔、心输出量、静脉混合血、呼吸顺应性和阻力以及氧气和二氧化碳交换。在以12次/分钟的通气频率进行一系列对照测量后,将频率加倍至50次/分钟,并调整潮气量和吸入氧浓度以维持血气张力恒定。在25次/分钟、6次/分钟,最后又回到25次/分钟时重复相同步骤。在每个频率下,吸呼比(I:E)保持在1/2,吸气气流波形形状保持恒定(快速上升后稳定下降至零),呼气为被动向大气呼出。平均结果表明,生理死腔随频率变化相对较小,因此在频率变为50次/分钟时死腔与潮气量之比显著增加(增加24%),而在频率变为6次/分钟时显著降低(降低46%)。心输出量和静脉混合血的变化要么不显著,要么处于显著边缘,这些变化的95%置信区间在心输出量增加14%、减少12%以内,静脉混合血在±心输出量的1.4%以内。得出的结论是,只要Paco2、Pa02和平均气道压保持恒定,通气频率并不重要,即使在很宽的范围内也是如此。

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