Suppr超能文献

[国产喷射呼吸机在全麻下硬质支气管镜介入操作中对犬的影响]

[The effects of a domestically made jet ventilator in dogs during interventional procedures by rigid bronchoscopy under general anesthesia].

作者信息

Yin Feng-xian, Zhang Jie, Ding Yan, Wang Ting, Xu Min, Wang Juan, Pei Ying-hua

机构信息

Department of Pulmonary Medicine, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2011 Nov;34(11):821-6.

Abstract

OBJECTIVE

To observe the effects of a domestically made jet ventilator in dogs during interventional procedures by rigid bronchoscopy under general anesthesia.

METHODS

Ten healthy mongrel dogs were inserted with a rigid bronchoscope under general anesthesia, and the dogs underwent 3 different ventilation conditions randomly: spontaneous breathing alone (group A), and normal frequency jet ventilation with spontaneous breathing (group B), normal frequency jet ventilation without spontaneous breathing (group C). When the interventional procedure lasted 30 min, 60 min, 90 min, 120 min, blood gas analysis was performed. Arterial blood gas analysis under different driving pressures (0.20 mPa, 0.25 mPa, 0.30 mPa) was compared when dogs underwent normal frequency jet ventilation without spontaneous breathing. Oxygen concentrations at the proximal end and the distal end of the rigid bronchoscope were measured out-of-body, when high pressure oxygen (FiO(2) 100%) was used to drive the normal frequency jet ventilation.

RESULTS

After the operation, PaCO(2) increased all the groups. In group C, PaCO(2) increased and pH decreased remarkably as compared with group A and group B (P < 0.01). In group C, PaO(2) decreased after the operation: compared with group A and group B, the difference being significant (P < 0.05). The ventilation effects of the jet ventilator was closely related with its driving pressure, and higher driving pressure improved the dog's oxygenation and the discharge of carbon dioxide. Under high pressure oxygen (FiO(2) 100%), oxygen concentration in the distal end of the rigid bronchoscope was lower than 50% whether (the driving pressures and I:E) was adjusted or not (P > 0.05). The oxygen concentration at the distal end of the rigid bronchoscope was increased a little (but below 50%) when jet needle tip inserted superficially or deeply into the adapter, but the oxygen was lower than 40% at most situation when it was in the midrange (3 - 6 centimeters in the adapter).

CONCLUSIONS

This domestically made jet ventilator could not provide enough effective ventilation during interventional procedures with rigid bronchoscopy under general anesthesia because hypoxemia and hypercapnia occurred when the operation time was prolonged. The PaO(2) and PaCO(2) of the dogs were better when spontaneous breathing was maintained during the procedure. The ventilation effects of the jet ventilator was closely related with its driving pressure. The oxygen concentration at the distal end of the rigid bronchoscope was lower than 40% in most situation when it was in the midrange (3 - 6 centimeters in the adapter) under high pressure oxygen (FiO(2) 100%). There was no significant change in the oxygen concentration with adjustment of the driving pressure or the I:E ratio of the jet ventilator.

摘要

目的

观察国产喷射呼吸机在全身麻醉下硬质支气管镜介入操作过程中对犬的通气效果。

方法

10只健康杂种犬在全身麻醉下插入硬质支气管镜,随机接受3种不同通气条件:单纯自主呼吸(A组)、自主呼吸下常频喷射通气(B组)、无自主呼吸下常频喷射通气(C组)。当介入操作持续30分钟、60分钟、90分钟、120分钟时,进行血气分析。在犬无自主呼吸下常频喷射通气时,比较不同驱动压力(0.20 mPa、0.25 mPa、0.30 mPa)下的动脉血气分析结果。当使用高压氧(FiO₂ 100%)驱动常频喷射通气时,体外测量硬质支气管镜近端和远端的氧浓度。

结果

术后所有组的PaCO₂均升高。与A组和B组相比,C组PaCO₂显著升高,pH显著降低(P < 0.01)。C组术后PaO₂降低:与A组和B组相比,差异有统计学意义(P < 0.05)。喷射呼吸机的通气效果与其驱动压力密切相关,较高的驱动压力可改善犬的氧合及二氧化碳排出。在高压氧(FiO₂ 100%)下,无论是否调整驱动压力和I:E,硬质支气管镜远端的氧浓度均低于50%(P > 0.05)。当喷射针尖端浅插或深插入适配器时,硬质支气管镜远端的氧浓度略有升高(但低于50%),但在适配器中段(3 - 6厘米)的大多数情况下,氧浓度最高低于40%。

结论

国产喷射呼吸机在全身麻醉下硬质支气管镜介入操作过程中不能提供足够有效的通气,因为操作时间延长时会出现低氧血症和高碳酸血症。操作过程中维持自主呼吸时犬的PaO₂和PaCO₂情况较好。喷射呼吸机的通气效果与其驱动压力密切相关。在高压氧(FiO₂ 100%)下,当喷射针位于适配器中段(3 - 6厘米)时,硬质支气管镜远端的氧浓度在大多数情况下低于40%。调整喷射呼吸机的驱动压力或I:E比,氧浓度无显著变化。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验