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气道和静脉负荷期间氦气和六氟化硫呼气图中的心源性振荡。

Cardiogenic oscillations in He and SF6 expirograms during airway and venous loading.

作者信息

Meyer M, Lewis S M, Mohr M, Schulz H, Schuster K D, Piiper J

机构信息

Department of Physiology, Max Planck Institute for Experimental Medicine, Göttingen, Federal Republic of Germany.

出版信息

J Appl Physiol (1985). 1990 Sep;69(3):945-55. doi: 10.1152/jappl.1990.69.3.945.

DOI:10.1152/jappl.1990.69.3.945
PMID:2123180
Abstract

Cardiogenic oscillations in the expired partial pressure profiles of two inert gases (He and SF6) were monitored in seven anesthetized paralyzed mechanically ventilated dogs. He and SF6 were administered either intravenously by a membrane oxygenator and partial arteriovenous bypass [venous loading (VL)] or by washin into lung gas [airway loading (AL)]. The single-breath expirograms obtained during constant-flow expiration after inspiration of test gas-free air displayed distinct and regular cardiogenic oscillations. The relative oscillation amplitude (ROA), calculated as oscillation amplitude divided by mixed expired-inspired partial pressure difference, was in the range of 1-8%. The ROA for both He and SF6 was approximately 4.2 times higher in VL than in AL, which indicated that among lung units that emptied sequentially in the cardiac cycle, the effects of alveolar ventilation-perfusion (VA/Q) inequality were more pronounced than those of alveolar ventilation-alveolar volume (VA/VA) inequality. In AL, He and SF6 oscillations were 180 degrees out of phase compared with CO2 and O2 oscillations and with He and SF6 oscillations in VL, which suggests that regions with low VA/VA had high VA/Q and very low Q/VA. The ROA was practically unaffected by breath holding in both AL and VL, which indicates that there was little diffusive or convective (cardiogenic) mixing between the lung units that were responsible for cardiogenic oscillations. The ROA was consistently higher for He than for SF6, and the He-to-SF6 ratio was independent of route of test gas loading, averaging 1.6 in both AL and VL. This result may be explained by laminar Taylor dispersion, whereby oscillations generated in peripheral lung regions are dissipated in inverse proportion to diffusion coefficient during transit through the proximal (larger) airways.

摘要

在七只麻醉、瘫痪并接受机械通气的犬中,监测了两种惰性气体(氦气和六氟化硫)呼出分压曲线中的心源性振荡。氦气和六氟化硫通过膜式氧合器和部分动静脉旁路进行静脉注射[静脉负荷(VL)],或者通过洗入肺气体进行[气道负荷(AL)]。在吸入无测试气体的空气后进行恒流呼气期间获得的单次呼吸呼气图显示出明显且规则的心源性振荡。相对振荡幅度(ROA),计算为振荡幅度除以混合呼出 - 吸入分压差值,范围为1 - 8%。氦气和六氟化硫的ROA在VL中比在AL中大约高4.2倍,这表明在心动周期中依次排空的肺单位中,肺泡通气 - 灌注(VA/Q)不平等的影响比肺泡通气 - 肺泡容积(VA/VA)不平等的影响更明显。在AL中,与二氧化碳和氧气振荡以及VL中的氦气和六氟化硫振荡相比,氦气和六氟化硫振荡相差180度,这表明VA/VA低的区域具有高VA/Q和非常低的Q/VA。在AL和VL中,屏气对ROA实际上没有影响,这表明负责心源性振荡的肺单位之间几乎没有扩散或对流(心源性)混合。氦气的ROA始终高于六氟化硫,并且氦气与六氟化硫的比率与测试气体加载途径无关,在AL和VL中平均为1.6。这一结果可以用层流泰勒弥散来解释,即外周肺区域产生的振荡在通过近端(较大)气道传输过程中与扩散系数成反比消散。

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