Effros Richard M, Hoagland Kelly W, Bosbous Mark, Castillo Daniel, Foss Bradley, Dunning Marshall, Gare Meir, Lin Wen, Sun Feng
Department of Medicine, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226, USA.
Am J Respir Crit Care Med. 2002 Mar 1;165(5):663-9. doi: 10.1164/ajrccm.165.5.2101018.
Most exhaled water is produced as gaseous water vapor, which can be collected in cooled condensers. The presence of nonvolatile solutes in these condensates suggests that droplets of respiratory fluid (RF) have also been collected. However, calculation of RF solute concentrations from condensates requires estimation of the dilution of RF droplets by water vapor. We used condensate electrolyte concentrations to calculate the dilution of RF droplets in condensates from 20 normal subjects. The total ionic concentration (conductivity) was 497 plus minus 68 (mean plus minus SEM) muM. Of this, 229 plus minus 43 muM was NH(4)(+), but little NH(4)(+) was collected from subjects with tracheostomies, indicating oral formation. The Na+ concentration in condensate (Na+) averaged 242 plus minus 43 muM. Large variations in Na(+) correlated well with variations of K+ in condensate (K+) and Cl-) in condensate (Cl-), and were attributed to differences in respiratory droplet dilution. Dividing condensate values of ([Na+] + [K+] ) by those of plasma indicated that RF represented between 0.01% and 2.00% of condensate volumes. Calculated values for Na+, K+, Cl-, lactate, and protein in RF were Na+ = 91 +/- 8 mM, K+ = 60 +/- 11 mM, Cl- = 102 +/- 17 mM, lactate = 44 +/- 17 mM, and protein = 7.63 +/- 1.82 g/dl, respectively.
呼出的大部分水分以气态水蒸气的形式产生,可在冷却冷凝器中收集。这些冷凝物中存在非挥发性溶质表明呼吸道液体(RF)的液滴也已被收集。然而,根据冷凝物计算RF溶质浓度需要估计水蒸气对RF液滴的稀释作用。我们利用冷凝物电解质浓度来计算20名正常受试者冷凝物中RF液滴的稀释情况。总离子浓度(电导率)为497±68(平均值±标准误)μM。其中,229±43μM为NH₄⁺,但气管切开术患者收集到的NH₄⁺很少,表明其来源于口腔。冷凝物中的Na⁺浓度(Na⁺)平均为242±43μM。Na⁺的大幅变化与冷凝物中K⁺(K⁺)和Cl⁻(Cl⁻)的变化密切相关,这归因于呼吸道液滴稀释的差异。将冷凝物中([Na⁺]+[K⁺])的值除以血浆中的值表明,RF占冷凝物体积的0.01%至2.00%。RF中Na⁺、K⁺、Cl⁻、乳酸和蛋白质的计算值分别为Na⁺=91±8 mM,K⁺=60±11 mM,Cl⁻=102±17 mM,乳酸=44±17 mM,蛋白质=7.63±1.82 g/dl。