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远端高频喷射通气时的气流分布与肺胸顺应性

Gas flow distribution in distal high frequency jet ventilation and lung thorax compliance.

作者信息

Spoelstra A J, Tamsma T J

机构信息

Laboratory for Physiology, Free University, Amsterdam, The Netherlands.

出版信息

Acta Anaesthesiol Scand. 1991 Nov;35(8):717-24. doi: 10.1111/j.1399-6576.1991.tb03378.x.

Abstract

To investigate the influence of changes in thorax and lung compliance on ventilation during distal High Frequency Jet Ventilation (HFJV), similar ventilator settings were compared before and after changing the compliance in two groups of anaesthetized mongrel dogs. Each period of distal HFJV was preceded by adequate Intermittent Positive Pressure Ventilation (IPPV) to assure a start with baseline values. In Group 1 (n = 7), thorax compliance was changed by chest strapping, while in Group 2 (n = 7) lung compliance was changed by inducing acute lung injury by injection of oleic acid into the right atrium. Gas flow distribution in the ventilatory circuit during distal HFJV was determined before and after the changes in compliance were induced. Comparing similar ventilator settings during distal HFJV in the same dog, a decrease in lung or thorax compliance led to changes in gas flow distribution in the ventilatory circuit. Entrainment was decreased and bypass increased with a negative effect on the gas volume entering the lungs and on gas exchange. The results indicate that distal HFJV should be regarded as pressure-limited ventilation.

摘要

为研究在远端高频喷射通气(HFJV)期间胸廓和肺顺应性变化对通气的影响,在两组麻醉的杂种犬中,比较了改变顺应性前后相似的呼吸机设置。在每次远端HFJV之前,先进行充分的间歇正压通气(IPPV),以确保从基线值开始。在第1组(n = 7)中,通过胸部捆绑改变胸廓顺应性,而在第2组(n = 7)中,通过向右心房注射油酸诱导急性肺损伤来改变肺顺应性。在诱导顺应性改变前后,测定远端HFJV期间通气回路中的气流分布。比较同一只犬在远端HFJV期间相似的呼吸机设置,肺或胸廓顺应性降低会导致通气回路中气流分布的改变。引气减少,旁路增加,对进入肺内的气体量和气体交换产生负面影响。结果表明远端HFJV应被视为压力限制通气。

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