在急性肺损伤犬模型中，俯卧位在部分液体通气期间可改善氧合，且无不良血流动力学影响。

Prone positioning improves oxygenation without adverse hemodynamic effects during partial liquid ventilation in a canine model of acute lung injury.

作者信息

Hwang Jung Hye, Kwon Yong Soo, Kang Eun Hae, Koh Won-Jung, Kang Kyeong Woo, Kim Ho Cheol, Chung Man Pyo, Kim Hojoong, Kwon O Jung, Suh Gee Young

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Intern Med. 2004 Dec;19(4):237-42. doi: 10.3904/kjim.2004.19.4.237.

DOI:10.3904/kjim.2004.19.4.237

PMID:15683112

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4531571/

Abstract

BACKGROUND

Partial liquid ventilation (PLV) and prone positioning can improve the arterial oxygenation (PaO2) in acute lung injury (ALI). We evaluated the effect of prolonged prone positioning during partial liquid ventilation (PLV) in a canine model of acute lung injury.

METHODS

Six mongrel dogs (weighing 17.4 +/- 0.7 kg each) were anesthetized, intubated and mechanically ventilated. After 1 hour of baseline stabilization, the dogs' lungs were instilled with 40 mL/kg perfluorocarbon (PFC). PLV was first performed in the supine position for 1 hour (S1), then in the prone position for 3 hours with hourly measurements (P1, P2, P3), and finally, PLV was performed with the animal turned back to the supine position for 1 hour (S2).

RESULTS

After instillation of the PFC, the PaO2 significantly increased from 992 +/- 32.6 mmHg at baseline to 198.1 +/- 59.2 mmHg at S1 (p = 0.001). When the dogs were turned to the prone position, the PaO2 further increased to 288.3 +/- 80.9 mmHg at P1 (p = 0.008 vs. S1): this increase was maintained for 3 hours, but the PaO2 decreased to 129.4 +/- 62.5 mmHg at S2 (p < 0.001 vs. P3). Similar changes were seen in the shunt fraction. There were no significant differences for the systemic hemodynamic parameters between the prone and supine positions.

CONCLUSION

Prolonged prone positioning during PLV in an animal model of ALI appears to improve oxygenation without any hemodynamic compromise.

摘要

背景

部分液体通气（PLV）和俯卧位可改善急性肺损伤（ALI）患者的动脉氧合（PaO2）。我们在急性肺损伤犬模型中评估了部分液体通气（PLV）期间延长俯卧位的效果。

方法

6只杂种犬（每只体重17.4±0.7 kg）麻醉后插管并进行机械通气。在基线稳定1小时后，向犬肺内注入40 mL/kg全氟化碳（PFC）。首先在仰卧位进行PLV 1小时（S1），然后在俯卧位进行3小时，每小时测量一次（P1、P2、P3），最后将动物转回仰卧位进行PLV 1小时（S2）。

结果

注入PFC后，PaO2从基线时的99.2±32.6 mmHg显著增加至S1时的198.1±59.2 mmHg（p = 0.001）。当犬转为俯卧位时，PaO2在P1时进一步升至288.3±80.9 mmHg（与S1相比，p = 0.008）：这种增加持续3小时，但在S2时PaO2降至129.4±62.5 mmHg（与P3相比，p < 0.001）。分流分数也有类似变化。俯卧位和仰卧位之间的全身血流动力学参数无显著差异。