Division for Experimental Anaesthesiology, University Medical Center Freiburg, Germany.
Respir Physiol Neurobiol. 2012 Oct 15;184(1):65-72. doi: 10.1016/j.resp.2012.08.006. Epub 2012 Aug 13.
We investigated the sustained effects of recruitment manoeuvres in terms of "recruitment memory" in healthy and lung injured rats. 46 ventilated rats were allocated to either the control (sham) or the lavage group. Two consecutive low-flow manoeuvres were performed before sham/lavage and hourly during a 2-h-observation period. The slopes of the inspiratory limbs of the two resulting pressure-volume loops were translated into compliance-volume curves. The difference between the two compliance curves was smaller after lavage (root-mean-square deviation: 0.065 ml/cm H2O control group, 0.038 ml/cm H2O lavage group; p<0.05) and stayed small during the whole experiment. In the control group, the deviation was small after sham manoeuvre but increased throughout the experiment. Compliance gain after recruitment was higher in the control group (0.1 ml/cm H2O) compared to the lavage group (0.02 ml/cm H2O, p<0.05). We conclude that lung lavage led to alveolar collapse not susceptible to recruitment manoeuvres. On the contrary in healthy lungs recruitment manoeuvres led to persistent lung recruitment which we interpret as recruitment memory.
我们研究了招募手法在健康和肺损伤大鼠中的“招募记忆”方面的持续效果。46 只通气大鼠被分配到对照组(假手术)或灌洗组。在假手术/灌洗前和观察期的每小时进行两次连续的低流量手法。两个由此产生的压力-容量环的吸气支斜率被转化为顺应性-容量曲线。灌洗后顺应性曲线之间的差异较小(均方根偏差:对照组 0.065 ml/cm H2O,灌洗组 0.038 ml/cm H2O;p<0.05),并且在整个实验过程中保持较小。在对照组中,假手术手法后偏差较小,但整个实验过程中逐渐增大。与灌洗组(0.02 ml/cm H2O)相比,对照组(0.1 ml/cm H2O)的募集后顺应性增加更高(p<0.05)。我们得出结论,肺灌洗导致肺泡塌陷,不易受招募手法影响。相反,在健康肺中,招募手法导致持续的肺募集,我们将其解释为招募记忆。