Runck Hanna, Schwenninger David, Haberstroh Jörg, Guttmann Josef
Department of Anesthesiology and Intensive Care Medicine, Division of Experimental Anesthesiology, University Medical Center Freiburg, Germany.
Department of Anesthesiology and Intensive Care Medicine, Division of Experimental Anesthesiology, University Medical Center Freiburg, Germany.
Respir Physiol Neurobiol. 2014 Nov 1;203:1-8. doi: 10.1016/j.resp.2014.08.010. Epub 2014 Aug 20.
We investigated the effects of recruitment maneuvers on subpleural alveolar area in healthy rats. 36 mechanically ventilated rats were allocated to either ZEEP-group or PEEP - 5cmH2O - group. The subpleural alveoli were observed using a transthoracal endoscopic imaging technique. Two consecutive low-flow maneuvers up to 30cmH2O peak pressure each were performed, interrupted by 5s plateau phases at four different pressure levels. Alveolar area change at maneuver peak pressures and during the plateau phases was calculated and respiratory system compliance before and after the maneuvers was analyzed. In both groups alveolar area at the second peak of the maneuver did not differ significantly compared to the first peak. During the plateau phases there was a slight increase in alveolar area. After the maneuvers, compliance increased by 30% in ZEEP group and 20% in PEEP group. We conclude that the volume insufflated by the low-flow recruitment maneuver is distributed to deeper but not to subpleural lung regions.
我们研究了复张手法对健康大鼠胸膜下肺泡面积的影响。36只机械通气的大鼠被分配到零呼气末正压（ZEEP）组或呼气末正压5cmH₂O组。使用经胸内镜成像技术观察胸膜下肺泡。进行了两次连续的低流量手法，每次峰值压力高达30cmH₂O，在四个不同压力水平下由5秒的平台期中断。计算手法峰值压力和平台期期间的肺泡面积变化，并分析手法前后的呼吸系统顺应性。在两组中，手法第二次峰值时的肺泡面积与第一次峰值相比无显著差异。在平台期期间，肺泡面积略有增加。手法后，ZEEP组的顺应性增加了30%，PEEP组增加了20%。我们得出结论，低流量复张手法注入的容积分布到更深的肺区域，而非胸膜下肺区域。
