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从运动到休息的转变。通气和动脉血气反应。

Transition from exercise to rest. Ventilatory and arterial blood gas responses.

作者信息

O'Neill A V, Johnson D C

机构信息

Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston 02114.

出版信息

Chest. 1991 May;99(5):1145-50. doi: 10.1378/chest.99.5.1145.

Abstract

The mechanisms leading to rapid changes in arterial blood gas values soon after exercise ends have not been well established. To further study these phenomena, we exercised seven normal male volunteers to exhaustion on a cycle ergometer with a 25-W/min ramped protocol measuring arterial blood gas values, and breath-by-breath gas exchange from rest to exercise and through 15 minutes of recovery. Arterial PO2 (PaO2) increased from 108 mm Hg at peak exercise to 125 mm Hg at 2 minutes of recovery. There was a smaller rise in calculated alveolar PO2 (PAO2) from 121 to 128 mm Hg over the same period. Arterial PCO2 (PaCO2) fell from 35.0 mm Hg to 31.9 mm Hg. The gas exchange ratio R rose from 1.21 to 1.52, after having peaked at 1.68 at 1 minute. The alveolar-arterial O2 gradient (P[A-a]O2) fell from 12.3 mm Hg at peak exercise to 3.2 mm Hg at 2 minutes. Following exercise, the rise in R is related to a more rapid fall in O2 uptake than in CO2 output, and the fall in P(A-a)O2 is probably related to improved V/Q relationships and to a rise in mixed venous PO2. We conclude that the rise in PaO2 in the recovery period after progressive nonsteady state exercise is due to several factors, including a fall in P(A-a)O2 and a rise in PAO2 due primarily to an elevation of R and also to a fall in PaCO2.

摘要

运动结束后不久动脉血气值迅速变化的机制尚未完全明确。为了进一步研究这些现象,我们让7名正常男性志愿者在功率自行车上进行递增负荷运动直至力竭,运动方案为每分钟增加25瓦,同时测量动脉血气值以及从静息到运动再到恢复15分钟期间的逐次呼吸气体交换情况。动脉血氧分压(PaO2)在运动峰值时为108毫米汞柱,恢复2分钟时升至125毫米汞柱。同期计算得出的肺泡氧分压(PAO2)从121毫米汞柱小幅升至128毫米汞柱。动脉血二氧化碳分压(PaCO2)从35.0毫米汞柱降至31.9毫米汞柱。气体交换率R从1.21升至1.52,在运动1分钟时曾达到峰值1.68。肺泡 - 动脉氧分压差(P[A-a]O2)从运动峰值时的12.3毫米汞柱降至恢复2分钟时的3.2毫米汞柱。运动后,R的升高与氧摄取比二氧化碳排出下降更快有关,而P(A-a)O2的下降可能与通气/血流比值改善以及混合静脉血氧分压升高有关。我们得出结论,在进行性非稳态运动后的恢复期,PaO2升高是由多种因素导致的,包括P(A-a)O2下降、PAO2升高(主要由于R升高)以及PaCO2下降。

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