Nishio Isuta
Department of Anesthesiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, 160, Tokyo, Japan.
J Anesth. 1996 Dec;10(4):282-288. doi: 10.1007/BF02483396.
To differentiate between the effects of respiratory and metabolic alkalosis on respiratory mechanics, respiratory system resistance (Rrs) and reactance (Xrs) were examined in anesthetized, paralyzed, and mechanically hyperventilated dogs. Rrs and Xrs were measured by the forced oscillation method with a random noise input of 0-25 Hz. Restoration to normocapnia by CO inhalation significantly increased Rrs (+23.4±4.0%), particularly at high-frequency ranges without alterations in Xrs or resonant frequencies, whereas an increase in pH without changes in partial pressure of arterial carbon dioxide (PaCO ) by an administration of bicarbonate-carbonate mixture resulted in no significant alteration in Rrs or Xrs. A significant decrease in Rrs (-16.3±2.5%) following vagotomy or atropine administration was no longer affected by CO inhalation. These results suggest that (1) the vagus nerve appears to play a role in maintaining the resting tension of airway smooth muscle, (2) systemic hypocapnia decreases Rrs presumably due to the central airway dilation, and (3) this response is associated with a change in systemic partial pressure of carbon dioxide (PCO ) rather than that in pH.
为了区分呼吸性碱中毒和代谢性碱中毒对呼吸力学的影响,我们在麻醉、麻痹并进行机械通气的犬类中检测了呼吸系统阻力(Rrs)和电抗(Xrs)。通过强迫振荡法,以0-25Hz的随机噪声输入来测量Rrs和Xrs。吸入CO使二氧化碳分压恢复至正常水平,显著增加了Rrs(+23.4±4.0%),特别是在高频范围内,而Xrs或共振频率没有改变;而通过给予碳酸氢盐-碳酸盐混合物使pH升高且动脉二氧化碳分压(PaCO₂)不变时,Rrs或Xrs没有显著改变。迷走神经切断或给予阿托品后,Rrs显著降低(-16.3±2.5%),吸入CO不再对其产生影响。这些结果表明:(1)迷走神经似乎在维持气道平滑肌的静息张力中起作用;(2)全身性低碳酸血症可能由于中央气道扩张而降低Rrs;(3)这种反应与全身性二氧化碳分压(PCO₂)的变化有关,而不是与pH的变化有关。