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关于低氧和高压应激对屏气潜水者肺气体交换影响的初步观察

Preliminary observations on the effect of hypoxic and hyperbaric stress on pulmonary gas exchange in breath-hold divers.

作者信息

Garbella Erika, Piarulli Andrea, Fornai Edo, Pingitore Alessandro, Prediletto Renato

机构信息

Extreme Center, Scuola Superiore, Sant'Anna and National Research Council-Tuscany Region "Gabriele Monasterio" Foundation, Pisa, Italy.

出版信息

Diving Hyperb Med. 2011 Jun;41(2):97-100.

Abstract

AIM

To evaluate pulmonary alveolar-capillary membrane integrity and ventilation/perfusion mismatch after breath-hold diving.

METHODS

Pulmonary diffusing capacity to carbon monoxide (DLCO) and nitric oxide (DLNO), haemoglobin (Hb) and haematocrit (Hct) were measured in six elite divers before and at 2, 10 and 25 minutes after a maximal breath-hold dive to a depth of 10 metres' sea water.

RESULTS

Compared to pre-dive, DLCO showed a slight increase at 2 minutes in five subjects and a tendency to decrease at 25 minutes (P < 0.001) in all subjects. DLNO showed an increase at 10 minutes in three divers and a slight decrease at 25 minutes in five subjects. There was a small but significant (P < 0.001) increase in Hb and Hct at 2 minutes, possibly affecting the DLCO measurements.

CONCLUSIONS

An early but transient increase in DLCO in five divers may reflect the central shift in blood volume during a breath-hold dive. The late parallel decrease in DLCO and DLNO likely reflects alveolar-capillary distress (interstitial oedema). The DLNO increase in three subjects at 10 minutes may suggest ventilation/perfusion mismatch.

摘要

目的

评估屏气潜水后肺泡 - 毛细血管膜的完整性及通气/灌注不匹配情况。

方法

在6名精英潜水员进行最大深度为10米海水的屏气潜水前、潜水后2分钟、10分钟和25分钟时,测量一氧化碳肺弥散量(DLCO)、一氧化氮肺弥散量(DLNO)、血红蛋白(Hb)和血细胞比容(Hct)。

结果

与潜水前相比,5名受试者在2分钟时DLCO略有增加,所有受试者在25分钟时均有下降趋势(P < 0.001)。3名潜水员在10分钟时DLNO增加,5名受试者在25分钟时略有下降。2分钟时Hb和Hct有小幅度但显著的增加(P < 0.001),可能影响了DLCO测量结果。

结论

5名潜水员早期但短暂的DLCO增加可能反映了屏气潜水期间血容量的中心转移。DLCO和DLNO后期平行下降可能反映了肺泡 - 毛细血管窘迫(间质性水肿)。3名受试者在10分钟时DLNO增加可能提示通气/灌注不匹配。

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