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氟烷麻醉期间人体对持续吸气性阻力和弹性负荷的通气代偿

Ventilatory compensation for continuous inspiratory resistive and elastic loads during halothane anesthesia in humans.

作者信息

Moote C A, Knill R L, Clement J

出版信息

Anesthesiology. 1986 May;64(5):582-9. doi: 10.1097/00000542-198605000-00007.

Abstract

Inspiratory mechanical loads were applied to the airway continuously for 5 min in healthy young adult volunteers maintained in a near steady-state of halothane anesthesia 1.1 MAC. The loads, both flow resistive and elastic in nature, had been selected to reduce the first loaded tidal volume approximately 10, 30 or 50%--these being designated "small," "medium," and "large" loads, respectively. The actual magnitudes of resistive load were 8 +/- 1, 21 +/- 3, and 48 +/- 6 cmH2O X l-1 X s, and of elastic load 6 +/- 1, 18 +/- 1, and 41 +/- 5 cmH2O X l-1 (mean +/- SEM). All loads caused an immediate reduction of ventilation proportional to the size of the load. This was followed by a gradual recovery of ventilation toward control values over approximately 2 min and then nearly stable ventilation for the rest of the loading period. Respiratory frequency was unchanged throughout. At 5 min of loading, ventilation and PaCO2 had been nearly steady for 3 min and O2 uptake and CO2 output at the airway were unchanged from control, suggesting the establishment of a near steady respiratory state. With the small and medium loads of both types, ventilation and PaCO2 in this near steady-state were not detectably different from control. With the large loads, however, ventilation was significantly reduced and PaCO2 slightly increased. The end-expiratory position of the chest wall and the relative contributions of the rib cage and abdomen-diaphragm to ventilation, as estimated by anteroposterior chest wall magnetometers, were not consistently altered by any load.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在维持于1.1 MAC氟烷麻醉近稳定状态的健康年轻成年志愿者中,对气道持续施加吸气机械负荷5分钟。这些负荷兼具流动阻力和弹性性质,被选定为使首次加载的潮气量分别减少约10%、30%或50%,分别称为“小”、“中”和“大”负荷。阻力负荷的实际大小分别为8±1、21±3和48±6 cmH₂O·L⁻¹·s,弹性负荷分别为6±1、18±1和41±5 cmH₂O·L⁻¹(均值±标准误)。所有负荷均导致通气量立即按负荷大小成比例减少。随后在约2分钟内通气量逐渐恢复至对照值,然后在剩余加载期内通气量几乎稳定。呼吸频率在整个过程中未改变。加载5分钟时,通气量和动脉血二氧化碳分压(PaCO₂)已近稳定3分钟,气道处的氧气摄取量和二氧化碳排出量与对照相比未改变,表明建立了近乎稳定的呼吸状态。对于两种类型的小负荷和中负荷,此近乎稳定状态下的通气量和PaCO₂与对照无明显差异。然而,对于大负荷,通气量显著减少,PaCO₂略有增加。通过前后胸壁磁力计估计的胸壁呼气末位置以及肋骨胸廓和腹部 - 膈肌对通气的相对贡献,均未因任何负荷而持续改变。(摘要截断于250字)

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