Sawa T, Yamauchi H, Kumazawa T, Ikezono E
Bull Tokyo Med Dent Univ. 1979 Mar;26(1):33-42.
The effect of cardiac output on pulmonary shunt was studied in living lungs of human patients and dogs which had alveoli and blood vessels, and also in artificial lung (bubble-type oxygenator) which had no such structural factors. In spite of such a structural difference, quite similar results were observed in both living and artificial lungs, and this suggests that some common factors other than the change in blood vessels result in the change in pulmonary shunt. It was observed that pulmonary shunt increased as the saturation of mixed venous blood became higher. It was clarified that the oxygen-receiving capacity of blood decreased as the oxygen saturation of mixed venous blood became higher. It was clarified that the oxygen-receiving capacity of blood decreased as the oxygen saturation became higher, i.e., the amount of reduced hemoglobin became less. The reduction in oxygen-receiving capacity of blood results in the reduction in oxygen-transfer efficiency from alveoli to blood and hence pulmonary shunt increases, and this can be regarded as a kind of shunt-like effect. It can be concluded that the change in pulmonary shunt by cardiac output is not due to the change in the lung function but is caused by the change in the oxygen-receiving capacity of the mixed venous blood.
在患有肺泡和血管的人类患者及犬类的活体肺脏中，以及在没有此类结构因素的人工肺（鼓泡式氧合器）中，研究了心输出量对肺内分流的影响。尽管存在这种结构差异，但在活体肺和人工肺中均观察到了相当相似的结果，这表明除血管变化之外的一些共同因素导致了肺内分流的变化。据观察，随着混合静脉血饱和度升高，肺内分流增加。已明确，随着混合静脉血氧饱和度升高，血液的携氧能力下降。已明确，随着氧饱和度升高，血液的携氧能力下降，即还原血红蛋白量减少。血液携氧能力的降低导致从肺泡到血液的氧转运效率降低，进而肺内分流增加，这可被视为一种类似分流的效应。可以得出结论，心输出量引起的肺内分流变化并非由于肺功能的改变，而是由混合静脉血携氧能力的变化所致。
