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在健康仔猪液体通气期间,吸入氧分数(FiO2)的变化会影响动脉血氧分压(PaO2),同时氧合血红蛋白的脑内浓度仅有轻微改变。

Changes in FiO2 affect PaO2 with minor alterations in cerebral concentration of oxygenated hemoglobin during liquid ventilation in healthy piglets.

作者信息

Burkhardt Wolfram, Proquitté Hans, Krause Susann, Wauer Roland R, Rüdiger Mario

机构信息

Clinic of Neonatology, Charité-Mitte, Schumannstrasse 20, 10098, Berlin, Germany.

出版信息

Intensive Care Med. 2004 Feb;30(2):315-320. doi: 10.1007/s00134-003-2090-7. Epub 2004 Jan 14.

Abstract

OBJECTIVE

To measure the impact of changes in the fraction of inspired oxygen (FiO2) on systemic and cerebral oxygen supply in gas and liquid ventilated healthy animals.

DESIGN

Interventional prospective animal study.

SETTING

University research laboratory.

PARTICIPANTS

Ten healthy, new-born piglets.

INTERVENTIONS

Variations in FiO2 during conventional mechanical ventilation (CMV) followed by partial liquid ventilation (PLV) with two different filling volumes of PF 5080 (10 vs. 30 ml/kg).

MEASUREMENTS AND RESULTS

Arterial blood gases were obtained 15 min after changing FiO2 and concentrations of cerebral oxygenated and total hemoglobin were determined with near infrared spectroscopy. During CMV an increase in FiO2 1.0 was associated with a constant rise in PaO2 but only a small increase in the cerebral concentration of oxygenated Hb. Initiation of PLV (at FiO2 of 1.0) caused a rapid drop in PaO2 towards values that were similar to CMV at FiO2 of 0.5. At FiO2 of 0.5 a reduction in oxygenated Hb was found in the 30 ml/kg filling group. Complete filling of the lungs with PFC caused a significant drop in total cerebral Hb concentration. CONCLUSIONS. According to our data, PLV in healthy lungs should be performed with a FiO2 of 1.0 and a small filling volume to avoid deterioration in cerebral oxygen supply.

摘要

目的

测量吸入氧分数(FiO2)变化对气体通气和液体通气的健康动物全身及脑氧供应的影响。

设计

干预性前瞻性动物研究。

地点

大学研究实验室。

参与者

10只健康新生仔猪。

干预措施

在传统机械通气(CMV)期间改变FiO2,随后进行部分液体通气(PLV),使用两种不同填充量的全氟戊烷(PF 5080,分别为10 vs. 30 ml/kg)。

测量指标与结果

改变FiO2后15分钟采集动脉血气,并用近红外光谱法测定脑氧合血红蛋白和总血红蛋白浓度。在CMV期间,FiO2增加至1.0与动脉血氧分压(PaO2)持续升高相关,但脑氧合血红蛋白浓度仅小幅增加。启动PLV(FiO2为1.0时)导致PaO2迅速下降至与FiO2为0.5时CMV相似的值。在FiO2为0.5时,30 ml/kg填充组的氧合血红蛋白减少。用全氟碳化合物完全填充肺导致脑总血红蛋白浓度显著下降。结论:根据我们的数据,健康肺进行PLV时应采用FiO2为1.0和小填充量,以避免脑氧供应恶化。

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