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吸入氧浓度对异氟烷麻醉马匹通气、通气节律和气体交换的影响。

Effects of inspired oxygen concentration on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses.

作者信息

Crumley Mariana N, McMurphy Rose M, Hodgson David S, Kreider Scott E

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.

出版信息

Am J Vet Res. 2013 Feb;74(2):183-90. doi: 10.2460/ajvr.74.2.183.

Abstract

OBJECTIVE

To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses.

ANIMALS

8 healthy adult horses.

PROCEDURES

In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% oxygen for 90 minutes. Measurements obtained during anesthesia included inspiratory and expiratory peak flow and duration, tidal volume, respiratory frequency, end-tidal CO(2) concentration, mixed expired partial pressures of CO(2) and O(2), PaO(2), PaCO(2), blood pH, arterial O(2) saturation, heart rate, and arterial blood pressure. Calculated values included the alveolar partial pressure of oxygen, alveolar-to-arterial oxygen tension gradient (PaO(2) - PaO(2)), rate of change of PAO(2) - PaO(2), and physiologic dead space ratio. Ventilatory rhythm, based on respiratory rate and duration of apnea, was continuously observed and recorded.

RESULTS

Use of the lower inspired oxygen fraction of 50% resulted in a lower arterial oxygen saturation and PaO(2) than did use of the higher fraction. No significant difference in PaCO(2), rate of change of PAO(2) - PaO(2), ventilatory rhythm, or other measured variables was observed between the 2 sessions.

CONCLUSION AND CLINICAL RELEVANCE

Use of 50% inspired oxygen did not improve the ventilatory rhythm or gas exchange and increased the risk of hypoxemia in spontaneously breathing horses during isoflurane anesthesia. Use of both inspired oxygen fractions requires adequate monitoring and the capacity for mechanical ventilation.

摘要

目的

比较吸入氧分数为50%和>95%时,对异氟烷麻醉马匹的通气、通气节律及气体交换的影响。

动物

8匹健康成年马。

步骤

采用交叉研究设计,马匹被随机安排接受2次麻醉过程,每次过程间隔1周。每次过程中,马匹先静脉注射盐酸赛拉嗪(1.0mg/kg)进行镇静,随后静脉注射地西泮(0.05mg/kg)和氯胺酮(2.2mg/kg)诱导麻醉。随后用异氟烷在50%或>95%的氧气中维持麻醉90分钟。麻醉期间测量的指标包括吸气和呼气峰值流速及持续时间、潮气量、呼吸频率、呼气末二氧化碳浓度、呼出气体中二氧化碳和氧气的分压、动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、血液pH值、动脉血氧饱和度、心率及动脉血压。计算值包括肺泡氧分压、肺泡 - 动脉氧分压差(PaO₂ - PaO₂)、PAO₂ - PaO₂的变化率及生理死腔率。基于呼吸频率和呼吸暂停持续时间的通气节律被持续观察和记录。

结果

与使用较高吸入氧分数相比,使用较低吸入氧分数50%时动脉血氧饱和度和PaO₂较低。两次过程之间在PaCO₂、PAO₂ - PaO₂变化率、通气节律或其他测量变量方面未观察到显著差异。

结论及临床意义

在异氟烷麻醉期间,使用50%的吸入氧并未改善通气节律或气体交换,反而增加了自主呼吸马匹发生低氧血症的风险。使用这两种吸入氧分数均需要充分监测及机械通气能力。

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