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准静态组织滞后现象对动态肺泡压力-容积环的影响。

Contribution of quasi-static tissue hysteresis to the dynamic alveolar pressure-volume loop.

作者信息

Robatto F M, Romero P V, Fredberg J J, Ludwig M S

机构信息

Meakins-Christie Laboratories, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.

出版信息

J Appl Physiol (1985). 1991 Feb;70(2):708-14. doi: 10.1152/jappl.1991.70.2.708.

DOI:10.1152/jappl.1991.70.2.708
PMID:2022563
Abstract

We obtained dynamic and flow-interrupted (quasi-static) pressure-volume loops from the lungs of anesthetized paralyzed open-chest mongrel dogs by measuring tracheal flow and pressure and alveolar pressure (PA) in three different regions using alveolar capsules. We used continuous tidal ventilation to obtain dynamic PA-volume loops and used the single-breath-interrupter technique to construct quasi-static pressure-volume loops for the same tidal volume (VT). We used three different VT's (15 and 20 ml/kg and inspiratory capacity) under control conditions and a VT of 15 ml/kg after methacholine-induced bronchoconstriction. We found that quasi-static hysteresis was negligible under control conditions for VT of 15 and 20 ml/kg. Quasi-static hysteresis became more important (36 +/- 11% of the corresponding dynamic PA-volume loop) during inspiratory capacity ventilation and after induced bronchoconstriction (27 +/- 12% of the corresponding dynamic PA-volume loop). We conclude that during tidal breathing near functional residual capacity "true" static hysteresis is negligible and that purely viscoelastic processes can explain lung mechanical behavior. For higher volume ventilation and after methacholine-induced constriction, quasi-static hysteresis accounted for a more important portion of dynamic tissue hysteresis. This suggests either that a more complex model, e.g., one including plastic processes, should be invoked or that the lung exhibits longer viscoelastic time constants as peak distending stresses become greater.

摘要

我们通过使用肺泡囊测量三只不同区域的气管流量、压力和肺泡压力(PA),从麻醉麻痹的开胸杂种犬的肺中获得了动态和流量中断(准静态)压力-容积环。我们使用持续潮气通气来获得动态PA-容积环,并使用单次呼吸中断技术为相同潮气量(VT)构建准静态压力-容积环。在对照条件下,我们使用了三种不同的VT(15和20 ml/kg以及吸气容量),在乙酰甲胆碱诱导支气管收缩后使用了15 ml/kg的VT。我们发现,在对照条件下,对于15和20 ml/kg的VT,准静态滞后可以忽略不计。在吸气容量通气期间和诱导支气管收缩后(相应动态PA-容积环的27±12%),准静态滞后变得更加重要(相应动态PA-容积环的36±11%)。我们得出结论,在接近功能残气量的潮气呼吸期间,“真正的”静态滞后可以忽略不计,并且纯粹的粘弹性过程可以解释肺的力学行为。对于更高容量的通气和乙酰甲胆碱诱导收缩后,准静态滞后在动态组织滞后中占更重要的部分。这表明要么应该引入一个更复杂的模型,例如一个包括塑性过程的模型,要么随着峰值扩张应力变得更大,肺表现出更长的粘弹性时间常数。

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