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高频通气期间中央气道模型中的纵向弥散

Longitudinal dispersion in model of central airways during high-frequency ventilation.

作者信息

van der Kooij A M, Luijendijk S C

机构信息

Department of Medical Physiology, State University of Utrecht, The Netherlands.

出版信息

Respir Physiol. 1991 Apr;84(1):13-29. doi: 10.1016/0034-5687(91)90016-c.

Abstract

We have measured the longitudinal dispersion of boluses of helium, acetylene and sulphur hexafluoride in a plastic model of the human airways--generations zero through six--during high frequency ventilation (HFV). HFV was maintained by a piston pump. Frequency f and tidal volume VT ranged from 2.5 to 25 Hz and from 5 to 20 ml, respectively. Boluses were injected near the entrance of the zeroth generation (trachea), and the dispersion curves were measured by mass spectrometry at the end of the sixth airway generation. The shapes of the bolus dispersion curves could be well described with Gaussian distribution functions. With the exception of the HFV-conditions with VT = 5 ml, the effective dispersion coefficient DDISP appeared to be independent of the molecular diffusion coefficient. This independency was also found by other investigators in studies with dogs and human subjects. The measured results for DDISP for different f and VT could be satisfactorily described with the empirical equation DDISP = 0.0617 f0.8VT1.38 [cm2S-1]. Application of this equation to f and VT values normally applied in man resulted in DDISP values which should be considered to be too small for maintaining eucapnic ventilation in vivo. On the basis of this result we believe that during HFV in intubated subjects gas transport by longitudinal dispersion will be limited to the instrumental dead space--the endotracheal tube inclusive--and a few generations of large bronchi.

摘要

我们在人体气道(从第零代到第六代)的塑料模型中,测量了氦气、乙炔和六氟化硫弹丸在高频通气(HFV)期间的纵向弥散情况。HFV由活塞泵维持。频率f和潮气量VT分别在2.5至25Hz和5至20ml范围内。弹丸在第零代(气管)入口附近注入,并通过质谱法在第六代气道末端测量弥散曲线。弹丸弥散曲线的形状可用高斯分布函数很好地描述。除了VT = 5ml的HFV条件外,有效弥散系数DDISP似乎与分子扩散系数无关。其他研究人员在对狗和人类受试者的研究中也发现了这种独立性。不同f和VT下DDISP的测量结果可用经验方程DDISP = 0.0617 f0.8VT1.38 [cm2S-1]令人满意地描述。将该方程应用于人体通常使用的f和VT值时,得到的DDISP值对于在体内维持正常二氧化碳分压通气来说应被认为过小。基于这一结果,我们认为在插管受试者的HFV期间,纵向弥散的气体传输将限于仪器死腔(包括气管内导管)和几代大支气管。

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