Wagner P D, Laravuso R B, Goldzimmer E, Naumann P F, West J B
J Appl Physiol. 1975 Jun;38(6):1099-109. doi: 10.1152/jappl.1975.38.6.1099.
We have recently described a new method for measuring distributions of ventilation-perfusion ratios (VA/Q) based on inert gas elimination. Here we report the initial application of the method in normal dogs and in dogs with pulmonary embolism, pulmonary edema, and pneumonia. Characteristic distributions appropriate to the known effects of each lesion were observed. Comparison with traditional indices of gas exchange revealed that the arterial PO2 calculated from the distributions agreed well with measured values, as did the shunts indicated by the method and by the arterial PO2 while breathing 100 per cent 02. Also the Bohr dead space closely matched the dispersion of ventilation in realtion to VA/Q. Assumptions made in the method were critically evaluated and appear justified. These include the existence of a steady state of gas exchange, an alveolar-end-capillary diffusion equilibration, and the fact that all of the observered VA/Q inequality occurs between gas exchange units in parallel. However, theoretical analysis suggests that the method can detect failure of diffusion equilbration across the blood-gas barrier should it exist. These results suggest that the method is well-suited to clinical investigation of patients with pulmonary disease.
我们最近描述了一种基于惰性气体消除来测量通气-灌注比(VA/Q)分布的新方法。在此,我们报告该方法在正常犬以及患有肺栓塞、肺水肿和肺炎的犬中的初步应用。观察到了与每种病变已知效应相符的特征性分布。与传统气体交换指标的比较表明,根据分布计算出的动脉血氧分压与测量值吻合良好,该方法所示的分流情况与呼吸100%氧气时的动脉血氧分压所示的分流情况也吻合良好。此外,玻尔死腔与通气相对于VA/Q的离散度紧密匹配。对该方法所做的假设进行了严格评估,结果表明这些假设是合理的。这些假设包括气体交换稳态的存在、肺泡-毛细血管扩散平衡,以及所有观察到的VA/Q不平等都发生在并行的气体交换单元之间这一事实。然而,理论分析表明,如果存在跨气血屏障的扩散平衡失败,该方法能够检测到。这些结果表明该方法非常适合对肺部疾病患者进行临床研究。