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温度会影响成熟胎儿肺初次充气-放气过程中的力学特性和稳定性。

Temperature affects mechanics and stability during initial inflation-deflation of mature fetal lung.

作者信息

Mautone A J, Antonio-Santiago M T, Clutario B C, Scarpelli E M

机构信息

Department of Anesthesiology, UMD-New Jersey Medical School, Newark 07103.

出版信息

Pediatr Pulmonol. 1992 Aug;13(4):203-8. doi: 10.1002/ppul.1950130406.

Abstract

Volume-pressure (VP) curves of initial aeration of mature (0.94-0.97 term) rabbit fetuses were compared in three groups, respectively, at 37 degrees C, with maximal inflation pressure of 25 cm H2O (P25); 22 degrees C, P25; and 22 degrees C, P30. Anesthetized fetuses were delivered through uterotomy; chest was opened; trachea of fetal pulmonary liquid (FPL)-filled lungs cannulated; and lungs inflated-deflated in 5 cm H2O, 2 min steps under continuous microscopic observation. As distending pressure was increased, FPL moved peripherally with airways inflation by free gas and with saccular recruitment by free gas and bubbles. Saccular aeration continued during initial reduction of P from Pmax. At end-deflation, air was retained in saccules virtually exclusively as bubbles. Airways inflation required less P at 37 degrees C, though airways volume (V) was the same at both temperatures. Opening P was lower, and saccular aeration was larger and more rapid at 37 degrees C. The apparently higher distensibility at 37 degrees C was most likely due to temperature effects on fluid dynamics rather than on tissue elasticity. Maximal V attained during early P reduction in all groups, was total lung capacity (TLC) at 37 degrees C and less than TLC at 22 degrees C. Air retention at end-deflation, with films of near-zero surface tension, was greatest at 37 degrees C and least at 22 degrees C, P25. Lung stability, greater at 37 degrees C than at 22 degrees C, was best discriminated when V at P0 was taken into account.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在三组实验中,分别比较了成熟(孕0.94 - 0.97期)兔胎儿在37℃、最大充气压力为25 cm H₂O(P25);22℃、P25;以及22℃、P30条件下初始通气的容积 - 压力(VP)曲线。通过子宫切开术娩出麻醉后的胎儿;打开胸腔;将充满胎儿肺液(FPL)的肺的气管插管;并在连续显微镜观察下,以5 cm H₂O、2分钟的步长对肺进行充气 - 放气。随着扩张压力增加,FPL随着气道被游离气体充气而向周边移动,并且随着游离气体和气泡使肺泡扩张而发生肺泡募集。在压力从Pmax开始初始降低期间,肺泡通气持续进行。在放气结束时,空气几乎完全以气泡形式保留在肺泡中。尽管在两个温度下气道容积(V)相同,但在37℃时气道充气所需的压力较低。在37℃时,起始压力较低,肺泡通气更大且更迅速。37℃时明显更高的扩张性最可能是由于温度对流体动力学的影响,而非对组织弹性的影响。在所有组中,早期压力降低期间达到的最大V值,在37℃时为肺总量(TLC),在22℃时小于TLC。放气结束时,表面张力接近零的液膜导致的空气潴留,在37℃时最大,在22℃、P25时最小。当考虑P0时的V值时,37℃时的肺稳定性比22℃时更好,这一点最易区分。(摘要截选至250字)

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