Cormier Y, Laviolette M, Atton L, Sériès F
Unité de recherche, Hôpital Laval, Québec, Canada.
Respir Physiol. 1991 Feb;83(2):179-87. doi: 10.1016/0034-5687(91)90027-g.
We measured the influence of changing the end-expiratory lung volume (EELV) on collateral resistance (Rcoll) in 6 normal volunteers (5 male, 1 female, aged 23-45 years). With subjects lying supine in an iron lung, a 5.3 mm fibroscope was introduced under local anesthesia and wedged into a sub-segmental bronchus of the right lower lobe. A truncated 5f Swan-Ganz catheter was tightly fitted into the suction port of the fibroscope. One lumen of the catheter served to deliver a constant flow (200 ml/min) of 5% CO2 in air. The pressure in the wedged segment (Ps) was measured by the other channel. Airway pressure (used as alveolar pressure (Palv)) was determined with a low bias flow catheter taped to the side of the bronchoscope, its tip positioned 20 cm from the end of the bronchoscope. Rcoll was obtained by the formula: Rcoll = (Ps-Palv)/flow. EELV was passively changed by applying a constant extrathoracic pressure in the iron lung at 5 cm H2O steps from 0 to +15 and from 0 to -20 cm H2O. The changes obtained in Rcoll (% baseline, mean +/- SEM) at each extrathoracic pressure (ETP) were: -5 cm H2O, 73 +/- 4%; -10, 56 +/- 7%; -15, 56 +/- 9%; -20, 35 +/- 10%; +5, 118 +/- 6%; +10, 129 +/- 7%; +15, 118 +/- 11%. Rcoll progressively decreased with increasing EELV (negative ETP) and increased slightly as EELV was reduced (positive ETP). The relationship between the log Rcoll and delta EELV was linear; the slope of this line was 9.8%.
我们测量了终末呼气肺容积（EELV）变化对6名正常志愿者（5名男性，1名女性，年龄23 - 45岁）侧支阻力（Rcoll）的影响。受试者仰卧于铁肺中，在局部麻醉下插入一根5.3毫米的纤维支气管镜，并楔入右下叶的一个亚段支气管。一根截断的5f Swan - Ganz导管紧密安装在纤维支气管镜的吸引口。导管的一个管腔用于输送恒定流量（200毫升/分钟）的5%二氧化碳与空气的混合气。楔入段的压力（Ps）通过另一通道测量。气道压力（用作肺泡压力（Palv））用一根低偏流导管贴在支气管镜侧面测定，其尖端位于距支气管镜末端20厘米处。Rcoll通过以下公式获得：Rcoll =（Ps - Palv）/流量。通过在铁肺中以5厘米水柱的步长从0到 +15厘米水柱以及从0到 -20厘米水柱施加恒定的胸外压力来被动改变EELV。在每个胸外压力（ETP）下Rcoll的变化（相对于基线的百分比，平均值±标准误）为：-5厘米水柱，73±4%；-10，56±7%；-15，56±9%；-20，35±10%；+5，118±6%；+10，129±7%；+15，118±11%。随着EELV增加（负的ETP），Rcoll逐渐降低，而随着EELV降低（正的ETP），Rcoll略有增加。log Rcoll与EELV变化量之间的关系是线性的；这条线的斜率为9.8%。
