Meinhardt Juergen P, Schmittner Marc, Herrmann Peter, Mailer Michael, Quintel Michael
Department of Anesthesiology and Intensive Care, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin der Universität Heidelberg, Mannheim, Germany.
ASAIO J. 2005 Jan-Feb;51(1):85-91. doi: 10.1097/01.mat.0000151923.48654.32.
The purpose of this study was to investigate the influence of different inhaled perfluorocarbons (PFC) upon pulmonary mechanics and gas exchange in a saline lavage model of acute lung injury. A randomized, controlled animal trial was conducted at the university hospital laboratory. Pulmonary gas exchange (pGE), static compliance (Cst), and basic hemodynamics (heart rate [HR], arterial [AP] and central venous pressures [CVP]) were compared. After induction of lung injury by repeated pulmonary lavage with saline solution, 35 New Zealand rabbits (3 +/- 0.2 kg) were randomized into five groups with seven animals each: 1) conventional ventilated control, 2) perfluorooctane (octane), 3) Perflubron (perfluorooctylbromide [PFOB]), 4) Perfluoro-1,3,5-trimethylcyclohexane (PP 4), and 5) perfluorohexane (hexane). Consecutively, PFC groups were subjected to a 120 minute study period applying mechanical ventilation (tidal volume of 7 ml/kg) in conjunction with PFC performed by a modified halothane vaporizer. Amount of vaporization was controlled by weighing the vaporizer at approximately 25 ml/h/kg body-weight PFC. Controls remained gas ventilated. After injury, PaO2 was control = 53 +/- 13 mbar, octane = 55 +/- 24 mbar, perflubron = 57 +/- 18 mbar, PP4 = 68 +/- 25 mbar, and hexane = 51 +/- 16 mbar. Within the 120 minute period, PaO2 was control = 51 +/- 19 mbar, octane = 42 +/- 6 mbar, perflubron = 40 +/- 11 mbar, PP4 = 47 +/- 10 mbar, and hexane = 60 +/- 8 mbar, respectively. At baseline, after injury, and throughout the study period, pGE and Cst, as well as HR, AP, and CVP, did not significantly differ when compared with octane, PP4, PFOB, and controls (p > 0.05), whereas hexane significantly improved pGE and Cst (p < 0.05). From four different inhaled perfluorocarbons, only perfluorohexane has measureable impact upon gas exchange and lung mechanics when compared with a conventional lung protective ventilation mode.
本研究的目的是在急性肺损伤的生理盐水灌洗模型中，研究不同吸入全氟碳化合物（PFC）对肺力学和气体交换的影响。在大学医院实验室进行了一项随机对照动物试验。比较了肺气体交换（pGE）、静态顺应性（Cst）和基本血流动力学指标（心率[HR]、动脉压[AP]和中心静脉压[CVP]）。在用盐溶液反复肺灌洗诱导肺损伤后，将35只新西兰兔（3±0.2千克）随机分为五组，每组7只：1）传统通气对照组；2）全氟辛烷（辛烷）组；3）全氟溴辛烷（PFOB）组；4）全氟-1,3,5-三甲基环己烷（PP 4）组；5）全氟己烷（己烷）组。随后，PFC组进行为期120分钟的研究，期间通过改良的氟烷蒸发器应用机械通气（潮气量7毫升/千克）并联合使用PFC。通过以约25毫升/小时/千克体重的PFC对蒸发器称重来控制蒸发量。对照组保持气体通气。损伤后，对照组的动脉血氧分压（PaO2）=53±13毫巴，辛烷组=55±24毫巴，全氟溴辛烷组=57±18毫巴，PP4组=68±25毫巴，己烷组=51±16毫巴。在120分钟内，对照组的PaO2=51±19毫巴，辛烷组=42±6毫巴，全氟溴辛烷组=40±11毫巴，PP4组=47±10毫巴，己烷组=60±8毫巴。在基线、损伤后及整个研究期间，与辛烷、PP4、PFOB组和对照组相比，pGE、Cst以及HR、AP和CVP均无显著差异（p>0.05），而己烷显著改善了pGE和Cst（p<0.05）。与传统的肺保护性通气模式相比，在四种不同的吸入全氟碳化合物中，只有全氟己烷对气体交换和肺力学有可测量的影响。
