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等碳酸血症通气时的局部气体传输:重力和呼吸频率的影响

Local gas transport in eucapnic ventilation: effects of gravity and breathing frequency.

作者信息

Venegas J G, Yamada Y, Burnham C, Hales C A

机构信息

Department of Biomedical Engineering, Massachusetts General Hospital, Boston.

出版信息

J Appl Physiol (1985). 1990 Jun;68(6):2287-95. doi: 10.1152/jappl.1990.68.6.2287.

Abstract

The effects of body position and respiratory frequency (f) on regional gas transport during eucapnic conventional ventilation (CV) and high-frequency ventilation (HFV) were assessed from the washout of nitrogen 13 (13NN) using positron-emission tomography. In one protocol, six dogs were ventilated with CV or HFV at f = 6 Hz and tidal volume (VT) selected supine for eucapnia. A coronal cross section of the lung base was studied in the supine, prone, and right and left lateral decubitus positions. In a second protocol, six dogs were studied prone: apical and basal cross sections were studied in CV and in HFV with f = 3 and 9 Hz at eucapnic VT. Regional alveolar ventilation per unit of lung volume (spVr) was calculated for selected regions and analyzed for gravity-dependent cephalocaudal and right-to-left gradients. In both CV and HFV, nonuniformity in spVr was highest supine and lowest prone. In CV there were vertical gradients of spVr in all body positions: nondependent less ventilated than dependent regions, particularly in the supine position. In HFV there was a moderate vertical gradient in spVr in addition to a preferentially ventilated central region in all body positions. Overall lung spV was unaffected by body position in CV but in HFV was highest supine and lowest prone. Nonuniformity in eucapnic prone HFV was unaffected by f and always higher than in CV.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

采用正电子发射断层扫描技术,通过氮13(¹³N)的洗脱,评估了在等碳酸常规通气(CV)和高频通气(HFV)期间,体位和呼吸频率(f)对局部气体传输的影响。在一个实验方案中,六只犬在f = 6 Hz和选定的潮气量(VT)下,仰卧位接受CV或HFV通气以维持等碳酸血症。研究了肺底部的冠状切面在仰卧位、俯卧位以及右侧和左侧卧位时的情况。在第二个实验方案中,对六只犬进行俯卧位研究:在等碳酸血症VT下,研究CV以及f = 3和9 Hz的HFV时的肺尖和肺底部切面。计算选定区域的单位肺容积局部肺泡通气量(spVr),并分析其重力依赖性的头尾方向和左右方向梯度。在CV和HFV中,spVr的不均匀性在仰卧位时最高,在俯卧位时最低。在CV中,所有体位下spVr均存在垂直梯度:非依赖区的通气量低于依赖区,尤其是在仰卧位时。在HFV中,除了所有体位下均有一个优先通气的中央区域外,spVr还存在适度的垂直梯度。在CV中,总体肺spV不受体位影响,但在HFV中,仰卧位时最高,俯卧位时最低。等碳酸血症俯卧位HFV时的不均匀性不受f影响,且始终高于CV。(摘要截短于250字)

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