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不同浓度异氟烷预处理对脂多糖诱导的幼年仔猪急性呼吸窘迫综合征模型呼吸力学、氧合及血流动力学的影响

Effects of different concentrations of isoflurane pretreatment on respiratory mechanics, oxygenation and hemodynamics in LPS-induced acute respiratory distress syndrome model of juvenile piglets.

作者信息

Fu Haibin, Sun Minli, Miao Changhong

机构信息

a Department of Anesthesiology , The Eye Ear Nose and Throat Hospital, Fudan University , Shanghai , China.

b Department of Anesthesiology , Zhongshan Hospital, Fudan University , Shanghai , China.

出版信息

Exp Lung Res. 2015;41(8):415-21. doi: 10.3109/01902148.2015.1054530. Epub 2015 Aug 28.

Abstract

PURPOSE

This study was prospectively designed to investigate the effects of different concentrations of isoflurane (ISO) pretreatment on respiratory mechanics, oxygenation, and hemodynamics in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) model of juvenile piglets.

METHODS

Twenty-four piglets (9-14 kg, 5-6 weeks old) were randomly assigned to four groups (n = 6): LPS group, which was injected with LPS (20 μg/kg) to induce ARDS; 0.5 ISO-LPS, 1.0 ISO-LPS, and 1.3 ISO-LPS groups, which were pretreated with 0.5, 1.0, and 1.3 minimum alveolar concentrations (MAC) ISO for 30 min before immediate LPS infusion, respectively. After establishment of ARDS, respiratory mechanism, oxygenation and hemodynamics parameters were measured at baseline, and 0, 1, 2, 3, and 4 hours after induction of ARDS.

RESULTS

After induction of ARDS, there were increases in alveolar-arterial oxygen difference (A-aDO2), oxygenation index (OI), mean airway pressure (MAP), dead space-to-tidal volume ratio, heart rate (HR), dP/dtmax, extravascular lung water index, pulmonary vascular permeability index, and PaCO2, and decreases in PaO2/FIO2, respiratory rate (RR), dynamic lung compliance (Cdyn), mean arterial blood pressure (MABP) and systemic vascular resistance (SVR) compared with baseline (P(time) < 0.05). Pretreatment with 1.0 and 1.3 MAC ISO alleviated changes in dP/dtmax and PaCO2 at ARDS 0-2 hours, SVR at 0-3 hours, PaO2/FIO2, RR, and MABP at 1-2 hours, HR at 2-3 hours, A-aDO2 at 3-4 hours, and OI at 4 hours (P(group) < 0.05).

CONCLUSION

Pretreatment with 1.0 and 1.3 MAC ISO had protective effects on respiratory mechanics, oxygenation, and hemodynamics in piglets with LPS-induced ARDS.

摘要

目的

本研究旨在前瞻性地探究不同浓度异氟烷(ISO)预处理对脂多糖(LPS)诱导的幼年仔猪急性呼吸窘迫综合征(ARDS)模型的呼吸力学、氧合及血流动力学的影响。

方法

将24只仔猪(9 - 14千克,5 - 6周龄)随机分为四组(每组n = 6):LPS组,注射LPS(20微克/千克)诱导ARDS;0.5 ISO-LPS组、1.0 ISO-LPS组和1.3 ISO-LPS组,分别在即刻输注LPS前用0.5、1.0和1.3最低肺泡有效浓度(MAC)的ISO预处理30分钟。建立ARDS模型后,在基线以及ARDS诱导后0、1、2、3和4小时测量呼吸机制、氧合及血流动力学参数。

结果

诱导ARDS后,与基线相比,肺泡-动脉血氧分压差(A-aDO2)、氧合指数(OI)、平均气道压(MAP)、死腔潮气量比、心率(HR)、dp/dtmax、血管外肺水指数、肺血管通透性指数和动脉血二氧化碳分压(PaCO2)升高,动脉血氧分压/吸入氧分数值(PaO2/FIO2)、呼吸频率(RR)、动态肺顺应性(Cdyn)、平均动脉血压(MABP)和体循环血管阻力(SVR)降低(P(时间)< 0.05)。用1.0和1.3 MAC的ISO预处理可减轻ARDS 0 - 2小时的dp/dtmax和PaCO2变化、0 - 3小时的SVR变化、1 - 2小时的PaO2/FIO2、RR和MABP变化、2 - 3小时的HR变化、3 - 4小时的A-aDO2变化以及4小时的OI变化(P(组)< 0.05)。

结论

用1.0和1.3 MAC的ISO预处理对LPS诱导的ARDS仔猪的呼吸力学、氧合及血流动力学具有保护作用。

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