Larsson A, Jonmarker C, Lindahl S G, Werner O
Department of Anaesthesia, University Hospital, Lund, Sweden.
Br J Anaesth. 1989 Apr;62(4):378-84. doi: 10.1093/bja/62.4.378.
We have measured dynamic lung compliance or static lung thorax compliance, functional residual capacity (FRC), and two indices of pulmonary gas mixing (pulmonary clearance delay (PCD) and single breath alveolar mixing efficiency (SBAME)) in 25 children in the supine and lateral decubitus position during nitrous oxide-halothane anaesthesia. Fifteen children (5 month-8 yr) breathed spontaneously and 10 (4 month-9 yr) underwent mechanical ventilation. Tidal volume and rate of ventilation were, respectively, 3.5-6.6 ml kg-1 and 22-46 b.p.m. in spontaneously breathing supine children, and 8.3-15 ml kg-1 and 20-30 b.p.m. in mechanically ventilated supine children, and did not differ significantly in the lateral position. There was no significant change in compliance when the child was turned to the lateral position, but FRC increased from 22 (SD7) to 25 (8) ml kg-1 (P less than 0.01) in the spontaneously breathing group and from 19 (6) to 24 (8) ml kg-1 (P less than 0.01) in the other group. In spontaneously breathing children, PCD and SBAME indicated a somewhat impaired pulmonary gas mixing (P less than 0.05) after the child had been turned to the lateral position, but no change occurred in the other group. These findings suggest that the distribution of ventilation in anaesthetized children in the lateral position is similar to that reported previously in anaesthetized adults.
我们在25名儿童氧化亚氮-氟烷麻醉期间，测量了仰卧位和侧卧位时的动态肺顺应性或静态肺胸顺应性、功能残气量（FRC）以及两个肺气体混合指标（肺清除延迟（PCD）和单次呼吸肺泡混合效率（SBAME））。15名儿童（5个月至8岁）自主呼吸，10名儿童（4个月至9岁）接受机械通气。自主呼吸仰卧位儿童的潮气量和通气频率分别为3.5 - 6.6 ml·kg⁻¹和22 - 46次/分钟，机械通气仰卧位儿童的潮气量和通气频率分别为8.3 - 15 ml·kg⁻¹和20 - 30次/分钟，侧卧位时两者无显著差异。儿童转为侧卧位时顺应性无显著变化，但自主呼吸组的FRC从22（标准差7）增加到25（8）ml·kg⁻¹（P＜0.01），另一组从19（6）增加到24（8）ml·kg⁻¹（P＜0.01）。在自主呼吸的儿童中，转为侧卧位后PCD和SBAME表明肺气体混合有所受损（P＜0.05），但另一组无变化。这些发现表明，麻醉儿童侧卧位时的通气分布与先前报道的麻醉成人相似。
