Rehder K, Sessler A D, Rodarte J R
J Appl Physiol Respir Environ Exerc Physiol. 1977 Mar;42(3):391-402. doi: 10.1152/jappl.1977.42.3.391.
Intrapulmonary distribution of ventilation/unit lung volume was studied in 28 volunteers in the sitting, supine, or right lateral decubitus position, either awake or anesthetized-paralyzed and mechanically ventilated. We found significant differences between the awake state and anesthesia-paralysis with mechanical ventilation in 1) intrapulmonary gas distribution, and 2) the vertical gradient of regional functional residual capacities for the subjects in the lateral decubitus position, but not for those in the sitting and supine positions. The effect of increasing the tidal volume on distribution of ventilation was significantly different 1) between the three body positions for a given state, and 2) between the two states for a given body position. The data suggest thoracoabdominal mechanics are different in the three body positions and that anesthesia-paralysis and mechanical ventilation may cause a different pattern of expansion of the respiratory system than spontaneous breathing in the awake state.
在28名志愿者处于坐位、仰卧位或右侧卧位时，对其清醒状态下或麻醉-肌松并机械通气状态下每单位肺容积的通气肺内分布情况进行了研究。我们发现，对于侧卧位的受试者，清醒状态与麻醉-肌松并机械通气状态在以下两方面存在显著差异：1）肺内气体分布；2）区域功能残气量的垂直梯度，但坐位和仰卧位的受试者不存在这种差异。对于给定状态，增加潮气量对通气分布的影响在三种体位之间存在显著差异；对于给定体位，在两种状态之间也存在显著差异。数据表明，三种体位下的胸腹力学不同，并且麻醉-肌松和机械通气可能导致呼吸系统的扩张模式与清醒状态下的自主呼吸不同。
