Anger C, van Bömmel T, Phadana-anek S, Reich A, Büter J, Stahl H, Deitmer T
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin Westfälischen-Wilhelms-Universität, Münster.
Anasth Intensivther Notfallmed. 1990 Feb;25(1):107-11.
Changes in relative humidity and temperature of the anaesthetic gases were measured in the inspiratory limb of the Dräger circle system next to the carbon dioxide absorber in 29 patients requiring ENT surgery under general anaesthesia. Immediately following intubation and prior to extubation, nasal and tracheal cytologic samples were taken with a brush technique and ciliary beat frequency was determined. At a fresh gas flow of 6 l/min, relative humidity increased from 57.6 +/- 1.5 to 62.5 +/- 1.8% (p less than 0.05) after 110 minutes. Temperature increased continuously from 21.96 +/- 0.97 degrees C to 23.83 +/- 0.48 degrees C after 200 minutes. The number of vital ciliated cells in the tracheal samples decreased from 24.4% following induction of anaesthesia to 6% at the end of anaesthesia (p less than 0.05), and from 35.7% to 26.8% (p less than 0.05) in the nasal samples. Ciliary beat frequency remained unchanged at the end of anaesthesia as compared to control in tracheal as well as in nasal samples. It is concluded that the output of relative humidity and temperature in the circle system is not sufficient to prevent broncho-epithelial damage. Ciliary beat automaticity appears to behave according to an all or nothing principle.
对29例接受全身麻醉的耳鼻喉科手术患者,在Drager循环系统靠近二氧化碳吸收器的吸气支中测量麻醉气体的相对湿度和温度变化。在插管后立即和拔管前,采用刷检技术采集鼻腔和气管细胞学样本,并测定纤毛摆动频率。在新鲜气流为6升/分钟时,110分钟后相对湿度从57.6±1.5%增加到62.5±1.8%(p<0.05)。200分钟后温度从21.96±0.97℃持续升高到23.83±0.48℃。气管样本中活纤毛细胞数量从麻醉诱导后24.4%降至麻醉结束时的6%(p<0.05),鼻腔样本中从35.7%降至26.8%(p<0.05)。与对照组相比,麻醉结束时气管和鼻腔样本中的纤毛摆动频率保持不变。得出结论,循环系统中相对湿度和温度的输出不足以防止支气管上皮损伤。纤毛摆动自动性似乎遵循全或无原则。