Piquet J, Isabey D, Chang H K, Harf A
Am Rev Respir Dis. 1986 Apr;133(4):605-8. doi: 10.1164/arrd.1986.133.4.605.
In order to evaluate the efficacy of ventilation by high frequency transthoracic oscillation in obstructive lung disease, we studied 10 anesthetized and paralyzed rabbits during experimental bronchoconstriction. In order to generate body surface oscillation, the animals were placed in a body-box connected to a piston pump. Two frequencies were successively applied in random order: 1 Hz, representing "conventional" ventilation, and 5 Hz for high frequency ventilation. During the control period, the magnitudes of the oscillation were adjusted such that the tidal volumes thus produced yielded normocapnia (PaCO2 = 40 +/- 2 mmHg) for at least 3 min at each frequency. The same tidal volumes were then used after a bronchoconstriction induced by aerosolized carbachol. We obtained a severe and stable bronchoconstriction and oscillated the animals at 1 and 5 Hz at identical tidal volumes as those used during the control period. Identical at the 2 frequencies of oscillation during the control period, the rate of CO2 elimination with bronchoconstriction was significantly higher (p less than 0.05) at 5 Hz (15.9 +/- 3.3 ml/min) than at 1 Hz (14.2 +/- 3.9 ml/min); PaCO2 was also significantly lower at 5 Hz than at 1 Hz. Mean arterial PO2 was significantly higher (p less than 0.01) at 5 Hz (58 +/- 4 mmHg) than at 1 Hz (46 +/- 12 mmHg) during bronchoconstriction. Mean alveolararterial O2 pressure difference was significantly lower (p less than 0.01) at 5 Hz (49 +/- 13 mmHg) than at 1 Hz (59 +/- 11 mmHg). Only a minor increase in lung volume was found during high frequency ventilation, and no significant hemodynamic changes occurred.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估高频经胸振荡通气在阻塞性肺疾病中的疗效,我们在实验性支气管收缩过程中对10只麻醉并麻痹的兔子进行了研究。为产生体表振荡,将动物置于与活塞泵相连的体箱中。以随机顺序先后施加两种频率:1Hz代表“传统”通气,5Hz用于高频通气。在对照期,调整振荡幅度,使由此产生的潮气量在每个频率下至少3分钟维持正常碳酸血症(动脉血二氧化碳分压[PaCO2]=40±2mmHg)。在雾化卡巴胆碱诱导支气管收缩后,使用相同的潮气量。我们获得了严重且稳定的支气管收缩,并以与对照期相同的潮气量对动物进行1Hz和5Hz的振荡。在对照期的两个振荡频率下相同,支气管收缩时5Hz(15.9±3.3ml/分钟)的二氧化碳清除率显著高于1Hz(14.2±3.9ml/分钟)(p<0.05);5Hz时的PaCO2也显著低于1Hz。支气管收缩期间,5Hz时的平均动脉血氧分压(PO2)显著高于1Hz(58±4mmHg比46±12mmHg,p<0.01)。5Hz时的平均肺泡-动脉氧分压差显著低于1Hz(49±13mmHg比59±11mmHg,p<0.01)。高频通气期间仅发现肺容积有轻微增加,且未发生明显的血流动力学变化。(摘要截短于250字)