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一种新型呼吸机-多容积描记仪系统在新生兔表面活性剂替代治疗效果测试中的应用。

Application of a new ventilator-multi-plethysmograph system for testing efficacy of surfactant replacement in newborn rabbits.

作者信息

Sun B, Kobayashi T, Cursted T, Grossmann G, Robertson B

机构信息

Research Unit for Experimental Perinatal Pathology, Dept of Pediatrics, St. Göran's Hospital, Stockholm.

出版信息

Eur Respir J. 1991 Mar;4(3):364-70.

PMID:1864353
Abstract

We applied a new ventilator-multi-plethysmograph system to evaluate the effect of surfactant replacement in newborn rabbits under well controlled, nearly physiological conditions characterized by normal ECG and adequate PCO2 in right ventricular heart blood obtained at the end of the experiment. Up to 10 animals were ventilated in parallel with a pressure-constant common respirator system. Using a working pressure of 4.9 kPa (50 cmH2O), we could adjust the pressure delivered to each animal within the range of 0.49-4.4 kPa (5-45 cmH2O), by changing the length of an open high-resistance tube constituting the outflow limb of the connection between the common ventilator tube and the tracheal cannula. Immature newborn animals obtained after 27.5 days gestation and ventilated for 30 min with a tidal volume of 8-10 ml.kg-1 had a mean +/- SD lung-thorax compliance of 4.2 +/- 1.1 ml.kPa-1.kg-1 (0.41 +/- 0.11 ml.cmH2O-1.kg-1) and PCO2 of 8.5 +/- 1.9 kPa. In littermates treated at birth with a large dose of natural surfactant (Curosurf, 200 mg.kg-1, compliance increased to 6.0 +/- 1.0 ml.kPa-1.kg-1 (0.68 +/- 0.10 ml.cmH2O-1.kg-1) (p less than 0.01) and PCO2 decreased to 6.9 +/- 1.2 kPa (p less than 0.01). Near-term animals, obtained at 30 days gestation and ventilated under similar conditions had a compliance of 7.2 +/- 0.9 ml.kPa-1.kg-1 (0.71 +/- 0.09 ml.cmH2O-1.kg-1) and PCO2 of 6.4 (1.2) kPa. Administration of surfactant (same dose as above) to these mature animals at birth had no adverse effects.

摘要

我们应用了一种新的呼吸机-多容积描记系统,在实验结束时获得的右心室心血中,以正常心电图和充足的PCO₂为特征的良好控制、近乎生理的条件下,评估新生兔表面活性剂替代治疗的效果。多达10只动物通过压力恒定的普通呼吸器系统并行通气。使用4.9 kPa(50 cmH₂O)的工作压力,我们可以通过改变构成普通通气管与气管插管连接流出端的开放高阻力管的长度,将输送给每只动物的压力调整在0.49 - 4.4 kPa(5 - 45 cmH₂O)范围内。妊娠27.5天后获得的未成熟新生动物,以8 - 10 ml·kg⁻¹的潮气量通气30分钟,其平均±标准差肺-胸顺应性为4.2±1.1 ml·kPa⁻¹·kg⁻¹(0.41±0.11 ml·cmH₂O⁻¹·kg⁻¹),PCO₂为8.5±1.9 kPa。出生时用大剂量天然表面活性剂(珂立苏,200 mg·kg⁻¹)治疗的同窝幼崽,顺应性增加到6.0±1.0 ml·kPa⁻¹·kg⁻¹(0.68±0.10 ml·cmH₂O⁻¹·kg⁻¹)(p<0.01),PCO₂降至6.9±1.2 kPa(p<0.01)。妊娠30天获得的近足月动物,在类似条件下通气,顺应性为7.2±0.9 ml·kPa⁻¹·kg⁻¹(0.71±0.09 ml·cmH₂O⁻¹·kg⁻¹),PCO₂为6.4(1.2)kPa。在出生时给这些成熟动物施用表面活性剂(与上述相同剂量)没有不良影响。

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