Iwao Y, Masuda J, Ochiai R, Higa S, Takeda J, Sekiguchi H, Nagano M
Department of Anesthesiology, Kyorin University School of Medicine, Tokyo.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Mar;29(3):338-44.
The difference in the uptake rate through the lungs between nitrous oxide and oxygen has been shown to represent the pulmonary capillary blood flow (Qc). The pulsatility of Qc, defined as the ratio of maximum Qc and mean Qc (Qc max/Qc), the ratio of Qc max and stroke volume (Qc max/SV), and the ratio of systolic Qc and SV (Vsyst/SV), has been also shown to indicate the pulmonary vasodilation as well as vasoconstriction. We measured Qc by means of body plethysmography in dogs with pulmonary air embolism, in order to evaluate its effect on the pulmonary vasculature. Ten adult dogs were anesthetized with pentobarbital and pancuronium, and were mechanically ventilated. A volume of air (0.5 ml/kg) was injected into the central vein. Although there was no significant change in systemic blood pressure, cardiac output, heart rate, and airway pressure after the injection of air, pulmonary arterial pressure and pulmonary vascular resistance increased significantly. Qc, Qc max, Qc max/Qc, and Qc max/SV decreased significantly after the air injection. Since these findings suggest that the pulmonary air embolism provoked pulmonary vasoconstriction, and attenuated the pulsatility of Qc, optimal pulmonary vasodilation therapy would be recommended to improve the pulmonary hypertension secondary to pulmonary air embolism.
一氧化二氮和氧气经肺的摄取率差异已被证明可代表肺毛细血管血流量(Qc)。Qc的搏动性,定义为最大Qc与平均Qc之比(Qc max/Qc)、Qc max与每搏量之比(Qc max/SV)以及收缩期Qc与SV之比(Vsyst/SV),也已被证明可指示肺血管舒张以及血管收缩。我们通过体容积描记法测量了患有肺空气栓塞的犬的Qc,以评估其对肺血管系统的影响。十只成年犬用戊巴比妥和泮库溴铵麻醉,并进行机械通气。将一定体积的空气(0.5 ml/kg)注入中心静脉。尽管注入空气后全身血压、心输出量、心率和气道压力无显著变化,但肺动脉压和肺血管阻力显著增加。注入空气后,Qc、Qc max、Qc max/Qc和Qc max/SV显著降低。由于这些发现表明肺空气栓塞引发了肺血管收缩,并减弱了Qc的搏动性,因此建议采用最佳的肺血管舒张疗法来改善继发于肺空气栓塞的肺动脉高压。