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人工通气和脱氢苯哌利多对患有门德尔松综合征犬呼吸系统早期变化发展的影响。

The effect of artifical ventilation and dehydrobenzperidol on the development of early changes in the respiratory system in dogs with Mendelson's syndrome.

作者信息

Budych W

出版信息

Anaesth Resusc Intensive Ther. 1975 Jan-Mar;3(1):15-23.

PMID:239609
Abstract

The experiments were carried out to observe certain functional changes in the respiratory system which develop in the early stage of aspiration pneumonia and to study the possibility of influencing these changes by application of artificial ventilation (IPPB) and/or administration of dehydrobenzperidol. The experiments were carried out on 32 mongrel dogs divided into 4 groups. Experimental Mendelson's syndrome was produced by instilling, during anaesthesia, hydrochloric acid solution of pH 1.5 in a dose of 4 ml/kg into the tracheobronchial tree. Immediately after anaesthesia and then 10 times at intervals of one hour after HCl instillation the following determinations were done: mean blood pressure, CVP, haematocrit, PO2 and PCO2 in arterial and mixed venous blood, and minute artifical ventilation. The veno-arterial blood shunt in the lungs, alveolo-arterial difference of oxygen partial pressure and the effective compliance were also determined. The chemical damage to the lungs by acid caused condensation of blood and a fall in CVP. These changes were due to fluid escape from the vessels especially in the pulmonary vascular tree. Disturbances in pulmonary gas exchange were a result of deficient ventilation of lung areas damaged primarily by acid and suffering secondarily from developing disturbances in pulmonary blood flow. Dehydrobenzperidol in a dose of 1 mg/kg applied as the only treatment in Mendelson's syndrome had the same favourable effect on pulmonary changes as controlled IPPB. The combination of controlled artificial ventilation and intravenous dehydrobenzperidol decreased the disturbances in pulmonary gas exchange in Mendelson's syndrome. This was possible because both factors exert a benficial effect on ventilation and perfusion preventing the development of oedema and atelectasis.

摘要

进行这些实验是为了观察吸入性肺炎早期呼吸系统发生的某些功能变化,并研究通过应用人工通气(间歇性正压通气)和/或给予脱氢苯哌利多来影响这些变化的可能性。实验在32只杂种狗身上进行,分为4组。在麻醉期间,将pH值为1.5、剂量为4 ml/kg的盐酸溶液滴入气管支气管树,制造实验性孟德尔森综合征。麻醉后立即以及在滴入盐酸后每隔一小时进行10次以下测定:平均血压、中心静脉压、血细胞比容、动脉血和混合静脉血中的氧分压和二氧化碳分压,以及每分钟人工通气量。还测定了肺内静脉-动脉血分流、肺泡-动脉氧分压差值和有效顺应性。酸对肺的化学损伤导致血液浓缩和中心静脉压下降。这些变化是由于液体从血管尤其是肺血管树中渗出所致。肺气体交换障碍是由于主要受酸损伤且继发于肺血流紊乱的肺区域通气不足所致。在孟德尔森综合征中,仅给予1 mg/kg剂量的脱氢苯哌利多治疗对肺部变化具有与对照间歇性正压通气相同的良好效果。控制性人工通气与静脉注射脱氢苯哌利多联合应用可减少孟德尔森综合征中的肺气体交换障碍。这是可能的,因为这两个因素对通气和灌注均有有益作用,可防止水肿和肺不张的发生。

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