Kwon O K, Satoh D, Yoshinari M, Obara S, Endoh K, Iwatsuki N, Hashimoto Y
Department of Anesthesiology, Catholic Medical College, Seoul, Korea.
Masui. 1991 Apr;40(4):574-9.
The effects of exogenous surfactant (SF) replacement therapy associated with high frequency jet ventilation (HFJV) on blood gas changes, pulmonary and hemodynamic variables were studied in canine lavaged lungs. The lungs were lavaged repeatedly with physiological saline until PaO2 decreased to 100 mmHg under intravenous pentobarbital anesthesia with 100% oxygen. SF (50 mg.kg-1) in the experimental group (n = 12) and saline in the control group (n = 8) were administered to the trachea using HFJV with a duration of 10 min. HFJV was further continued for 1 hour to make surfactant distribute evenly. Then respiration was controlled by the conventional mechanical ventilator for 3 hrs. During the administration of SF (10 min). PaCO2 was not altered. In the surfactant group, PaO2 improved significantly (200 mmHg) at the end of HFJV and was maintained for the next 3 hrs at this level, but it did not improve in the saline group. Therefore, we suggest that HFJV can be used safely for the treatment of acute respiratory failure and is an effective method for the administration of the pulmonary surfactant into the alveoli.
在犬肺灌洗模型中，研究了外源性表面活性物质（SF）替代疗法联合高频喷射通气（HFJV）对血气变化、肺和血流动力学指标的影响。在静脉注射戊巴比妥钠麻醉并吸入100%氧气的条件下，用生理盐水反复灌洗肺脏，直至动脉血氧分压（PaO2）降至100 mmHg。实验组（n = 12）经气管给予SF（50 mg·kg-1），对照组（n = 8）经气管给予生理盐水，均采用HFJV，持续10分钟。继续HFJV 1小时以使表面活性物质均匀分布。然后用传统机械通气控制呼吸3小时。在给予SF期间（10分钟），动脉血二氧化碳分压（PaCO2）无变化。在表面活性物质组，HFJV结束时PaO2显著改善（达200 mmHg），并在接下来的3小时维持在此水平，但生理盐水组未改善。因此，我们认为HFJV可安全用于治疗急性呼吸衰竭，是将肺表面活性物质注入肺泡的有效方法。
