Bull Joseph L, Foley David S, Bagnoli Paola, Tredici Stefano, Brant David O, Hirschl Ronald B
Biomedical Engineering Department, The University of Michigan, Ann Arbor, MI 48109, USA.
ASAIO J. 2005 Nov-Dec;51(6):781-8. doi: 10.1097/01.mat.0000179252.02471.9e.
The effects of end-inspiratory lung volume (EILV) and expiratory flow rate (Q) on the location of flow limitation in liquid-filled lungs were investigated by measuring pressure along the airways and by radiographic imaging. The lungs of New Zealand white rabbits were filled with perfluorocarbon to the randomly selected EILV of 20, 30, or 40 ml/kg, and the volume was actively drained at one of three Q: 2.5, 5.0, or 7.5 ml/s. The minimum pressures recorded by a movable catheter at locations along the airways show that flow limitation occurred in the main bronchi and trachea, and was independent of EILV and Q. The minimum pressure at the trachea was -80 mm Hg compared with values that were more positive than -10 mm Hg at a location 3 cm distal to the carina for all EILV and Q combinations. This location was confirmed by the lung images. The airway diameters gradually decreased with time, until flow limitation occurred. In airways distal to the collapse, there was not a significant decrease in diameter. Based on these data, we conclude that flow limitation in liquid-filled lungs occurs in the trachea and main bronchi and its location is independent of EILV or Q.
通过沿气道测量压力和进行影像学检查,研究了吸气末肺容积(EILV)和呼气流量(Q)对充满液体的肺中气流受限位置的影响。将新西兰白兔的肺用全氟化碳填充至随机选择的20、30或40 ml/kg的EILV,并以2.5、5.0或7.5 ml/s这三种Q值之一主动排出气体。沿气道各位置的可移动导管记录的最小压力表明,气流受限发生在主支气管和气管,且与EILV和Q无关。与所有EILV和Q组合在隆突远端3 cm处比-10 mmHg更正的值相比,气管处的最小压力为-80 mmHg。肺图像证实了该位置。气道直径随时间逐渐减小,直至出现气流受限。在塌陷远端的气道中,直径没有显著减小。基于这些数据,我们得出结论,充满液体的肺中的气流受限发生在气管和主支气管,其位置与EILV或Q无关。