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[肺部高频喷射通气期间的气体交换与呼吸力学]

[Gas exchange and respiration mechanics during high-frequency jet ventilation of the lungs].

作者信息

Zil'ber A P, Shurygin I A, Tikhova G P

出版信息

Vestn Akad Med Nauk SSSR. 1990(3):26-30.

PMID:2353532
Abstract

Gas exchange and pulmonary mechanics in high frequency-jet ventilation (HFJV) were studied during intubation anesthesia in patients with normal respiratory organs. The HFJV frequency ranged from 100 to 400 per minute. The tidal volumes (VT) varied from 50 to 140 ml. Gas exchange was studied in 11 patients, the total number of regimens amounting to 69. The physiological dead space volume (VD) was determined by the Bohr method for different combinations of VT and frequency after 15-minute ventilation with each regimen. The values of VD and VA were found to have linear relationships with VT and no relation to the ventilation frequency. Linear regression equations were derived for these relationships. The dynamic pulmonary distension in HFJV was assessed in 9 patients using the interrupted HFJV techniques, up to 28 regimen being tested for each patient. An exponential relationship between the accumulated gas volume and VT was found at fixed frequency values and duration of the expiratory phase. The regimen capacity for inducing gas accumulation in the lungs is determined by the ratio of ventilation frequency to the expiration time (accumulation coefficient). The dynamic pulmonary distention in HFJV is attended with a rise in mean respiratory pressure which, however, remains lower than the mean alveolar pressure. The obtained evidence should be taken into account when choosing an optimal regimen for individual HFJV.

摘要

对呼吸器官正常的患者在插管麻醉期间进行了高频喷射通气(HFJV)时的气体交换和肺力学研究。HFJV频率为每分钟100至400次。潮气量(VT)为50至140毫升。对11例患者进行了气体交换研究,方案总数达69个。每种方案通气15分钟后,采用玻尔法测定不同VT和频率组合下的生理死腔量(VD)。发现VD和VA值与VT呈线性关系,与通气频率无关。得出了这些关系的线性回归方程。采用间断HFJV技术对9例患者进行了HFJV时的动态肺扩张评估,每位患者测试多达28种方案。在固定频率值和呼气期持续时间时,发现累积气体量与VT之间存在指数关系。肺部诱导气体积聚的方案能力由通气频率与呼气时间之比(积聚系数)决定。HFJV时的动态肺扩张伴随着平均呼吸压力升高,不过该压力仍低于平均肺泡压力。在为个体选择最佳HFJV方案时应考虑所获得的证据。

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