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喘气犬的肺气体交换:高频通气模型

Pulmonary gas exchange in panting dogs: a model for high frequency ventilation.

作者信息

Meyer M, Hahn G, Piiper J

机构信息

Department of Physiology, Max Planck Institute for Experimental Medicine, Göttingen, FRG.

出版信息

Acta Anaesthesiol Scand Suppl. 1989;90:22-7. doi: 10.1111/j.1399-6576.1989.tb02998.x.

DOI:10.1111/j.1399-6576.1989.tb02998.x
PMID:2929260
Abstract

Panting in animals can be expected to represent a naturally occurring physiological counterpart to today's techniques of mechanical high-frequency ventilation. To analyze the mechanisms underlying the gas exchange inefficiency during ventilation with high frequencies, steady-state pulmonary gas exchange was studied in seven conscious dogs (32 kg mean body weight) during panting elicited by mild thermal stress. The animals had a chronic tracheostomy and an exteriorized carotid artery loop and were exposed to 27.5 degrees C ambient temperature for 2 h (65% relative humidity). Open-circuit techniques were used and PO2 and PCO2 from the tracheostomy tube were continuously monitored by mass spectrometry using a special sample-hold phase-locked gas sampling technique. PO2 and PCO2 were determined in arterial blood collected from the carotid artery. During the exposure, the following variables of steady-state gas exchange were determined (means +/- SD): breathing frequency 313 +/- 19 min-1; tidal volume, 167 +/- 21 ml; total ventilation, 52 +/- 9 l.min-1; effective alveolar ventilation, 5.5 +/- 1.3 l.min-1; partial pressures (torr; a, arterial; E', end-tidal): PaO2, 106.2 +/- 5.9; PaCO2, 27.2 +/- 3.9; (PE'-Pa)O2, 26.0 +/- 5.3; (Pa-PE')CO2, 14.9 +/- 2.5. According to the conventional lung model, parallel-dead space ventilation (ventilation of unperfused lung regions) would account for about 55% of the alveolar ventilation and for 2/3 of the (PE'-Pa)O2 difference. However, the lack of an 'alveolar plateau' in the CO2 and O2 expirograms suggests that incomplete serial mixing in peripheral airways contributes to the enhanced gas exchange inefficiency during panting as reflected in the increased blood/gas differences for O2 and CO2.

摘要

动物的喘息可以被认为是与当今机械高频通气技术相对应的一种自然发生的生理现象。为了分析高频通气时气体交换效率低下的潜在机制,在轻度热应激引起的喘息过程中,对7只清醒犬(平均体重32千克)的稳态肺气体交换进行了研究。这些动物做了慢性气管造口术并将颈动脉做成了体外环,使其暴露于27.5摄氏度的环境温度下2小时(相对湿度65%)。采用开路技术,通过特殊的采样保持锁相气体采样技术,利用质谱仪连续监测气管造口管处的PO2和PCO2。从颈动脉采集动脉血来测定PO2和PCO2。在暴露期间,测定了以下稳态气体交换变量(平均值±标准差):呼吸频率313±19次/分钟;潮气量167±21毫升;总通气量52±9升/分钟;有效肺泡通气量5.5±1.3升/分钟;分压(托;a,动脉血;E',呼气末):动脉血氧分压(PaO2)106.2±5.9;动脉血二氧化碳分压(PaCO2)27.2±3.9;(呼气末氧分压-动脉血氧分压)[(PE'-Pa)O2]26.0±5.3;(动脉血二氧化碳分压-呼气末二氧化碳分压)[(Pa-PE')CO2]14.9±2.5。根据传统的肺模型,平行无效腔通气(未灌注肺区域的通气)约占肺泡通气量的55%,占(呼气末氧分压-动脉血氧分压)差值的2/3。然而,二氧化碳和氧气呼气图中缺乏“肺泡平台”表明,外周气道中不完全的串联混合导致了喘息时气体交换效率的提高,这反映在氧气和二氧化碳的血/气差值增加上。

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