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犬肺切除术后的心肺适应性。I. 最大运动表现

Cardiopulmonary adaptations to pneumonectomy in dogs. I. Maximal exercise performance.

作者信息

Hsia C C, Herazo L F, Johnson R L

机构信息

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9034.

出版信息

J Appl Physiol (1985). 1992 Jul;73(1):362-7. doi: 10.1152/jappl.1992.73.1.362.

Abstract

Maximal exercise performance was evaluated in four adult foxhounds after right pneumonectomy (removal of 58% of lung) and compared with that in seven sham-operated control dogs 6 mo after surgery. Maximal O2 uptake (ml O2.min-1.kg-1) was 142.9 +/- 1.9 in the sham group and 123.0 +/- 3.8 in the pneumonectomy group, a reduction of 14% (P less than 0.001). Maximal stroke volume (ml/kg) was 2.59 +/- 0.10 in the sham group and 1.99 +/- 0.05 in the pneumonectomy group, a reduction of 23% (P less than 0.005). Lung diffusing capacity (DL(CO)) (ml.min-1.Torr-1.kg-1) reached 2.27 +/- 0.08 in the combined lungs of the sham group and 1.67 +/- 0.07 in the remaining lung of the pneumonectomy group (P less than 0.001). In the pneumonectomy group, DL(CO) of the left lung was 76% greater than that in the left lung of controls. Blood lactate concentration and hematocrit were significantly higher at exercise in the pneumonectomy group. We conclude that, in dogs after resection of 58% of lung, O2 uptake, cardiac output, stroke volume, and DL(CO) at maximal exercise were restricted. However, the magnitude of overall impairment was surprisingly small, indicating a remarkable ability to compensate for the loss of one lung. This compensation was achieved through the recruitment of reserves in DL(CO) in the remaining lung, the development of exercise-induced polycythemia, and the maintenance of a relatively large stroke volume in the face of an increased pulmonary vascular resistance.

摘要

对4只成年猎狐犬在右肺切除术后(切除58%的肺组织)的最大运动能力进行评估,并与7只假手术对照犬在术后6个月的情况进行比较。假手术组的最大摄氧量(ml O₂·min⁻¹·kg⁻¹)为142.9±1.9,肺切除组为123.0±3.8,降低了14%(P<0.001)。假手术组的最大每搏输出量(ml/kg)为2.59±0.10,肺切除组为1.99±0.05,降低了23%(P<0.005)。假手术组双肺的肺弥散容量(DL(CO))(ml·min⁻¹·Torr⁻¹·kg⁻¹)达到2.27±0.08,肺切除组剩余肺的该值为1.67±0.07(P<0.001)。在肺切除组中,左肺的DL(CO)比对照组左肺高76%。肺切除组运动时血乳酸浓度和血细胞比容显著更高。我们得出结论,在切除58%肺组织的犬中,最大运动时的摄氧量、心输出量、每搏输出量和DL(CO)受到限制。然而,总体损伤程度惊人地小,表明其具有显著的能力来补偿单肺缺失。这种补偿是通过调动剩余肺中DL(CO)的储备、运动诱导的红细胞增多症的发展以及在肺血管阻力增加的情况下维持相对较大的每搏输出量来实现的。

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