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持续气道正压通气对麻醉状态下人体气管刺激反射反应的影响。

Influence of CPAP on reflex responses to tracheal irritation in anesthetized humans.

作者信息

Nishino T, Sugimori K, Hiraga K, Hond Y

机构信息

Department of Anesthesiology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

J Appl Physiol (1985). 1989 Sep;67(3):954-8. doi: 10.1152/jappl.1989.67.3.954.

Abstract

We investigated the effects of lung inflation during continuous positive airway pressure breathing (CPAP) on airway defensive reflexes in 10 enflurane-anesthetized spontaneously breathing humans. The airway defensive reflexes were induced by instillation into the trachea of 0.5 ml of distilled water at two different levels of end-expiratory pressure (0 and 10 cmH2O CPAP). The tracheal irritation at an end-expiratory pressure of 0 cmH2O caused a variety of reflex responses including apnea, spasmodic panting, expiration reflex, cough reflex, an increase in heart rate, and an increase in blood pressure. Lung inflation during CPAP of 10 cmH2O did not exert any influence on these reflex responses in terms of the types, latencies, and durations of reflex responses although the intensity of the expiration reflex and cough reflex was augmented by lung inflation. Our results suggest that the pulmonary stretch receptors do not play an important role in the mechanisms of airway defensive reflexes in humans.

摘要

我们研究了持续气道正压通气(CPAP)期间肺膨胀对10名接受安氟醚麻醉的自主呼吸患者气道防御反射的影响。在两个不同的呼气末压力水平(0和10 cmH₂O CPAP)下,通过向气管内滴注0.5 ml蒸馏水来诱发气道防御反射。呼气末压力为0 cmH₂O时的气管刺激引发了多种反射反应,包括呼吸暂停、痉挛性喘气、呼气反射、咳嗽反射、心率增加和血压升高。尽管肺膨胀增强了呼气反射和咳嗽反射的强度,但10 cmH₂O CPAP期间的肺膨胀对这些反射反应的类型、潜伏期和持续时间均未产生任何影响。我们的结果表明,肺牵张感受器在人类气道防御反射机制中并不起重要作用。

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