Konrad F, Schreiber T, Grünert A, Clausen M, Ahnefeld F W
Clinic for Anesthesiology, University of Ulm, Germany.
Chest. 1992 Nov;102(5):1377-83. doi: 10.1378/chest.102.5.1377.
The objectives of this study were to evaluate a method for measuring BTV in ventilated patients and to study the short-term effect of general anesthesia with midazolam, Fentanyl, pancuronium and O2:N2O on BTV.
The study included phantom measurements on a bronchoscopy model and the determination of BTV in patients in a convenience sample trial.
The study took place in a university hospital.
Fourteen patients undergoing major abdominal surgery with planned postoperative mechanical ventilation were included in the study. All patients gave their written informed consent to participate in the study.
Bronchial mucus transport velocity was measured with a small volume (0.05 to 0.08 ml) of technetium 99m-labeled albumin microspheres with an activity of 3 MBq. The radiolabeled bolus was deposited on the dorsal mucosal surface at the distal end of the right and left main bronchus via flexible bronchoscopy. The movement of the microspheres toward the trachea was visualized and recorded using a scintillation camera; quantitative evaluation utilized the condensed image.
The technique was validated in a bronchoscopy model and in an intubated patient by moving a radioactive drop in a catheter through the main bronchi at velocities from 0 to 20 mm/min. The velocities determined by the image processing technique correlated well with the data by the model and patient determination (right bronchus, r = 1.0; left bronchus, r = 1.0). In seven ventilated patients, mechanical irritation by the fiberscope produced no significant effect on BTV. The BTV was measured preoperatively in seven conscious patients one day before surgery while they received local anesthesia with 10 ml of 1 percent lidocaine and postoperatively while they received intubation anesthesia. The preoperative and postoperative BTV values showed no significant differences (10.5; 5.7 to 13.7 mm/min; vs 9.7 (3.7 to 15.3) (median with range).
By this method, bronchial transport velocity can be determined in a relatively short time in ventilated patients. General anesthesia with midazolam, Fentanyl, pancuronium and O2:N2O does not influence BTV.
本研究的目的是评估一种测量通气患者支气管黏液转运速度（BTV）的方法，并研究咪达唑仑、芬太尼、泮库溴铵和O₂:N₂O全身麻醉对BTV的短期影响。
该研究包括在支气管镜模型上进行模拟测量以及在一项便利样本试验中测定患者的BTV。
该研究在一家大学医院进行。
14例计划术后机械通气的腹部大手术患者纳入研究。所有患者均书面知情同意参与研究。
用少量（0.05至0.08 ml）99m锝标记的白蛋白微球（活度为3 MBq）测量支气管黏液转运速度。通过柔性支气管镜将放射性团块沉积在左右主支气管远端的背侧黏膜表面。使用闪烁相机观察并记录微球向气管的移动；定量评估采用浓缩图像。
通过以0至20 mm/min的速度在导管中移动放射性液滴，在支气管镜模型和插管患者中验证了该技术。图像处理技术测定的速度与模型和患者测定的数据相关性良好（右支气管，r = 1.0；左支气管，r = 1.0）。在7例通气患者中，纤维支气管镜的机械刺激对BTV无显著影响。在7例清醒患者术前一天接受10 ml 1%利多卡因局部麻醉时以及术后接受插管麻醉时测量BTV。术前和术后BTV值无显著差异（10.5；5.7至13.7 mm/min；对比9.7（3.7至15.3）（中位数及范围）。
通过这种方法，可以在通气患者中相对较短的时间内测定支气管转运速度。咪达唑仑、芬太尼、泮库溴铵和O₂:N₂O全身麻醉不影响BTV。
