Kasaba T, Kosaka Y
Department of Anesthesiology, Shimane Medical University, Izumo, Japan.
J Anesth. 1988 Sep 1;2(2):170-5. doi: 10.1007/s0054080020170.
The effect of differential lung ventilation (DLV) on afferent vagal and efferent phrenic nerve activities was studied in urethane anesthetized cats. One endotracheal tube was inserted into the left bronchus to ventilate its side lung. Another tube was inserted until its tip reached about 1 cm above the carina to ventilate the right lung. Using two respirators, each lung was ventilated independently. Using hooked silver electrodes, the vagal and phrenic nerve activities were recorded. The afferent vagal nerve was activated in concurrence with lung inflation at any ventilation rate. The right and left vagal nerves were activated by right and left lung ventilation, respectively. On the other hand, the right and left efferent phrenic nerves were synchronized, whether the ventilation was discussed or ventilation was achieved by right or left one lung ventilation or even by asynchronous DLV. The phrenic nerve activity was surpressed by one-lung, right or left, ventilation independently, so that the rhythm of the phrenic nerve was disturbed by asynchronous DLV. From these results, to reduce the stress of patients during asychronous DLV, it was considered that patients need heavier sedation than a usual mechanical ventilatory support.
在氨基甲酸乙酯麻醉的猫身上研究了差异肺通气(DLV)对迷走神经传入和膈神经传出活动的影响。将一根气管插管插入左支气管以对其侧肺进行通气。另一根插管插入直到其尖端到达隆突上方约1厘米处,以对右肺进行通气。使用两台呼吸机,每个肺独立通气。使用钩状银电极记录迷走神经和膈神经的活动。在任何通气速率下,迷走神经传入在肺充气时同时被激活。右迷走神经和左迷走神经分别由右肺和左肺通气激活。另一方面,无论通气是双侧进行还是通过右肺或左肺单肺通气甚至是通过异步DLV实现,右膈神经和左膈神经传出都是同步的。膈神经活动被单独的单肺通气(右肺或左肺)抑制,因此膈神经的节律被异步DLV扰乱。从这些结果来看,为了减轻患者在异步DLV期间的应激,认为患者需要比通常机械通气支持时更深度的镇静。