Launois S, Similowski T, Fleury B, Aubier M, Murciano D, Housset B, Pariente R, Derenne J P
Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Eur Respir J. 1990 May;3(5):573-8.
We have investigated the transition from apnoea to spontaneous breathing in five comatose patients self intoxicated with barbiturates and carbamates. All patients were apnoeic on admission, and were studied throughout the course of recovery. The transition between the first respiratory movements and a stable and nearly normal ventilation (stable respiratory activity) ranged from 15 to 105 min, a very short time compared to the duration of the apnoeic state that lasted 6 to 72 h from admission. Minute ventilation and occlusion pressure during the first respiratory movements were 6.3 +/- 2.7 l.min-1 and 1.35 +/- 0.45 kPa, respectively. These values increased by roughly 50 and 100% by the time stable respiratory activity was achieved. The increase in minute ventilation was entirely due to an increased inspiratory flow, in relation to a proportionate increase in occlusion pressure, and without significant changes in the respiratory times or in the effective elastance. We conclude that the transition between apnoea and stable respiratory activity is characterized by its rapidity, by the fact that respiratory times are fixed throughout the recovery process, and by the fact that effective elastance is high.
我们研究了5例因巴比妥类药物和氨基甲酸酯类药物中毒而昏迷的患者从呼吸暂停到自主呼吸的转变过程。所有患者入院时均无呼吸，且在整个恢复过程中接受了研究。首次呼吸运动与稳定且接近正常通气（稳定呼吸活动）之间的转变持续时间为15至105分钟，与入院后持续6至72小时的呼吸暂停状态持续时间相比，这是一段非常短的时间。首次呼吸运动时的分钟通气量和阻断压分别为6.3±2.7升·分钟⁻¹和1.35±0.45千帕。到达到稳定呼吸活动时，这些值分别增加了约50%和100%。分钟通气量的增加完全是由于吸气流量增加，与阻断压的相应增加有关，且呼吸时间或有效弹性没有显著变化。我们得出结论，呼吸暂停与稳定呼吸活动之间的转变具有快速性、恢复过程中呼吸时间固定以及有效弹性高的特点。
