* Staff Anesthetist, # Professor and Head of the Intensive Care Unit, ** Professor and Chair of the Department, Department of Anesthesia and Intensive Care, Carl Gustav Carus University Hospital, University of Technology, Dresden, Germany. † Senior Scientist, ‖ Professor, Head of the Division of Radiopharmaceutical Biology, Institute of Radiopharmacy, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany. ‡ Senior Scientist, § Professor, Head of the Institute of Anatomy, University of Technology.
Anesthesiology. 2013 Oct;119(4):890-900. doi: 10.1097/ALN.0b013e3182a17e5b.
After gastric aspiration events, patients are at risk of pulmonary dysfunction and the development of severe acute lung injury and acute respiratory distress syndrome, which may contribute to the development of an inflammatory reaction. The authors' aim in the current study was to investigate the role of the spatial distribution of pulmonary blood flow in the pathogenesis of pulmonary dysfunction during the early stages after acid aspiration.
The authors analyzed the pulmonary distribution of radiolabeled microspheres in normal (n = 6) and injured (n = 12) anesthetized rat lungs using positron emission tomography, computed tomography, and histological examination.
Injured regions demonstrate increased pulmonary blood flow in association with reduced arterial pressure and the deterioration of arterial oxygenation. After acid aspiration, computed tomography scans revealed that lung density had increased in the injured regions and that these regions colocalized with areas of increased blood flow. The acid was instilled into the middle and basal regions of the lungs. The blood flow was significantly increased to these regions compared with the blood flow to uninjured lungs in the control animals (middle region: 1.23 [1.1; 1.4] (median [25%; 75%]) vs. 1.04 [1.0; 1.1] and basal region: 1.25 [1.2; 1.3] vs. 1.02 [1.0; 1.05], respectively). The increase in blood flow did not seem to be due to vascular leakage into these injured areas.
The data suggest that 10 min after acid aspiration, damaged areas are characterized by increased pulmonary blood flow. The results may impact further treatment strategies, such as drug targeting.
胃抽吸事件后，患者存在发生肺功能障碍和严重急性肺损伤及急性呼吸窘迫综合征的风险，这可能导致炎症反应的发生。作者在本研究中旨在探讨在酸性抽吸后早期肺功能障碍发病机制中肺血流空间分布的作用。
作者使用正电子发射断层扫描、计算机断层扫描和组织学检查分析了正常（n = 6）和损伤（n = 12）麻醉大鼠肺中放射性标记微球的肺分布。
损伤区域表现为肺血流增加，同时伴有动脉压降低和动脉氧合恶化。酸性抽吸后，计算机断层扫描显示损伤区域的肺密度增加，这些区域与血流增加区域相重合。酸性物质被注入肺的中部和基底区域。与对照动物未受损肺的血流相比，这些区域的血流明显增加（中部区域：1.23 [1.1；1.4]（中位数[25%；75%]）与 1.04 [1.0；1.1]，基底区域：1.25 [1.2；1.3]与 1.02 [1.0；1.05]）。血流增加似乎不是由于血管渗漏到这些受损区域。
这些数据表明，在酸性抽吸后 10 分钟，受损区域的特征是肺血流增加。结果可能会影响进一步的治疗策略，如药物靶向。
