Lindahl S, Arborelius M, Okmian L
Acta Anaesthesiol Scand. 1979 Aug;23(4):379-94. doi: 10.1111/j.1399-6576.1979.tb01465.x.
The influence of ventilatory frequency and the ventilator's "internal state of gas compression" (Cvent) on mechanics of ventilation, pulmonary ventilation, gas distribution, gas exchange and lung perfusion was studied with free airway and experimental regional airway obstruction in 10 piglets (7-12 kg b. w. ), using a tidal volume ventilator. The VDphy/VTexp ratio was greater at f = 30 than at f = 10.3 cycles/min. This could be related to a significant increase in the VDanat/VTexp ratio at f = 30, while VDc/VTexp and VDlav/VTexp were unchanged at both frequencies. With regional ventilation and perfusion within the obstructed pulmonary field were reduced, compared to the values at f = 10.3 cycles/min. With Cvent 20 ml/kPa, the tidal volumes were insufflated in a shorter time and with a higher initial tracheal peak pressure than with Cvent 80 ml/kPa. Following bronchial obstruction, VA, RQ and Pao2 were greater with Cvent 20 than with Cvent 80 ml/kPa. With Cvent 20, the ventilation of the lung bases was reduced, which was compensated for by a large increase in ventilation within the apical areas of the lungs, while gas distribution within the unobstructed areas was more evenly distributed with Cvent 80. Ventilation at Cvent 20 showed no essential advantage over Cvent 80. Only in lungs extremely difficult to ventilate and with ventilatory frequencies over 50 cycles/min could possible indications for Cvent 20 be seen.
使用潮气量通气机,在10头体重7 - 12千克的仔猪中,通过建立游离气道和实验性局部气道阻塞,研究了通气频率和通气机的“气体压缩内部状态”(Cvent)对通气力学、肺通气、气体分布、气体交换和肺灌注的影响。VDphy/VTexp比值在f = 30时高于f = 10.3次/分钟时。这可能与f = 30时VDanat/VTexp比值显著增加有关,而VDc/VTexp和VDlav/VTexp在两个频率下均无变化。与f = 10.3次/分钟时的值相比,阻塞肺野内的局部通气和灌注减少。当Cvent为20 ml/kPa时,潮气量在更短时间内吹入,初始气管峰值压力高于Cvent为80 ml/kPa时。支气管阻塞后,Cvent为20 ml/kPa时的VA、RQ和Pao2高于Cvent为80 ml/kPa时。当Cvent为20时,肺底部的通气减少,这通过肺尖部通气的大幅增加得到补偿,而Cvent为80时,未阻塞区域内的气体分布更均匀。Cvent为20时的通气与Cvent为80时相比没有本质优势。只有在极难通气且通气频率超过50次/分钟的肺部,才可能看到使用Cvent为20的指征。