Scherer R, Vigfusson G, Lawin P
Acta Anaesthesiol Scand. 1986 Jan;30(1):2-6. doi: 10.1111/j.1399-6576.1986.tb02355.x.
The purpose of this experimental study was to compare two methods of pulmonary blood flow manipulation during one-lung ventilation (OLV), either reducing pulmonary blood flow to the non-ventilated lung by inflation of a pulmonary artery catheter balloon (PAB) or by infusion of prostaglandin F2 alpha (PGF2 alpha). Seven anaesthetized dogs were intubated with a Kottmeier endobronchial tube and ventilated with 66% O2. Systemic and pulmonary pressures and blood gases, cardiac output and airway pressure were measured, and the venous admixture (QSP/QT) was calculated. During two-lung ventilation (TLV) Pao2 was 43.6 +/- 1.9 kPa (mean +/- s.d.) and (QSP/QT) was 11 +/- 3%. OLV reduced Pao2 to 12.1 +/- 1.6 kPa (P less than or equal to 0.001) and increased QSP/QT to 40 +/- 4% (P less than or equal to 0.001). Mean pulmonary artery pressure and airway pressure increased. PAB inflation caused an increase in Pao2 to 19.9 +/- 2.9 kPa (P less than or equal to 0.02) and a decrease in QSP/QT to 27 +/- 6% (P less than or equal to 0.001). PGF2 alpha infusion (1.2 micrograms kg-1 min-1) into the pulmonary artery of the non-ventilated lung increased Pao2 to 22.4 +/- 3.3 kPa (P less than or equal to 0.001) and decreased QSP/QT to 25 +/- 4 (P less than or equal to 0.001). PGF2 alpha infusion resulted in a small increase in mean systemic and pulmonary artery pressures. During the infusion of 1.2 micrograms kg-1 min-1 of PGF2 alpha no signs of bronchoconstriction were observed. PAB inflation and PGF2 alpha infusion were equally effective in improving oxygenation and reducing venous admixture during OLV.(ABSTRACT TRUNCATED AT 250 WORDS)
本实验研究的目的是比较单肺通气(OLV)期间两种肺血流调控方法,即通过肺动脉导管球囊(PAB)充气或输注前列腺素F2α(PGF2α)来减少非通气肺的肺血流。七只麻醉犬经Kottmeier支气管内导管插管,并用66%的氧气进行通气。测量全身和肺动脉压力、血气、心输出量和气道压力,并计算静脉混合血(QSP/QT)。在双肺通气(TLV)期间,动脉血氧分压(Pao2)为43.6±1.9 kPa(平均值±标准差),QSP/QT为11±3%。OLV使Pao2降至12.1±1.6 kPa(P≤0.001),并使QSP/QT增加至40±4%(P≤0.001)。平均肺动脉压和气道压力升高。PAB充气使Pao2升高至19.9±2.9 kPa(P≤0.02),QSP/QT降低至27±6%(P≤0.001)。向非通气肺的肺动脉输注PGF2α(1.2微克/千克·分钟)使Pao2升高至22.4±3.3 kPa(P≤0.001),QSP/QT降低至25±4(P≤0.001)。PGF2α输注导致平均全身和肺动脉压略有升高。在输注1.2微克/千克·分钟的PGF2α期间,未观察到支气管收缩迹象。在OLV期间,PAB充气和PGF2α输注在改善氧合和减少静脉混合血方面同样有效。(摘要截短于250字)