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正常人体暴露于高压空气和氧气下时的动脉及肺动脉血流动力学与氧输送/摄取情况。

Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen.

作者信息

Weaver Lindell K, Howe Steve, Snow Gregory L, Deru Kayla

机构信息

Hyperbaric Medicine, LDS Hospital, Eighth Ave. and C St., Salt Lake City, UT 84143, USA.

出版信息

J Appl Physiol (1985). 2009 Jul;107(1):336-45. doi: 10.1152/japplphysiol.91012.2008. Epub 2009 Apr 30.

Abstract

Divers and hyperbaric chamber attendants breathe hyperbaric air routinely. Hyperbaric oxygen (HBO(2)) is used therapeutically frequently. Although much is understood about the hemodynamic physiology and gas exchange effects during hyperbaric air and HBO(2) exposure, arterial and pulmonary arterial (PA) catheter data, including blood gas values during hyperbaric air and HBO(2) exposure of normal humans, have not been reported. We exposed 10 healthy volunteers instrumented with arterial and PA catheters to air at 0.85, 3.0, 2.5, 2.0, 1.3 (decompression stop), 1.12 (decompression stop), and 0.85 atm abs (our altitude) and then at identical pressures breathing O(2) followed by atmospheric pressure air while we measured arterial and PA pressures (PAP), cardiac output (Q), and blood gas measurements from both arterial and PA catheters. Although hemodynamic changes occurred during exposure to both hyperbaric air and HBO(2), we observed a greater magnitude of change under HBO(2) conditions: heart rate changes ranged from -9 to -19% (air to O(2)), respiratory rate from -12 to -17%, Q from -7 to -18%, PAP from -18 to -19%, pulmonary vascular resistance from -38 to -48%, and right-to-left shunt fraction from -87 to -107%. Mixed venous CO(2) fell 8% from baseline during HBO(2) despite mixed venous O(2) tensions of several hundred Torr. The stroke volume, O(2) delivery, and O(2) consumption did not change across exposures. The arterial and mixed venous partial pressures of O(2) and contents were elevated, as predicted. O(2) extraction increased 37% during HBO(2).

摘要

潜水员和高压舱工作人员经常呼吸高压空气。高压氧(HBO₂)也经常用于治疗。尽管人们对高压空气和HBO₂暴露期间的血流动力学生理和气体交换效应有很多了解,但关于正常人在高压空气和HBO₂暴露期间的动脉和肺动脉(PA)导管数据,包括血气值,尚未见报道。我们让10名装有动脉和PA导管的健康志愿者在0.85、3.0、2.5、2.0、1.3(减压停留)、1.12(减压停留)和0.85绝对大气压(我们所处的海拔高度)下呼吸空气,然后在相同压力下呼吸O₂,之后再呼吸常压空气,同时我们测量动脉和PA压力(PAP)、心输出量(Q)以及来自动脉和PA导管的血气测量值。尽管在高压空气和HBO₂暴露期间都发生了血流动力学变化,但我们观察到在HBO₂条件下变化幅度更大:心率变化范围为-9%至-19%(从空气到O₂),呼吸频率从-12%至-17%,Q从-7%至-18%,PAP从-18%至-19%,肺血管阻力从-38%至-48%,右向左分流分数从-87%至-107%。尽管混合静脉O₂张力达到几百托,但在HBO₂期间混合静脉CO₂从基线下降了8%。整个暴露过程中,每搏输出量、O₂输送量和O₂消耗量均未改变。正如预期的那样,动脉和混合静脉的O₂分压和含量均升高。在HBO₂期间,O₂摄取增加了37%。

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