van Vught A J, Versprille A, Jansen J R
Department of Pulmonary Diseases, Erasmus University, Rotterdam, The Netherlands.
Intensive Care Med. 1987;13(5):315-22. doi: 10.1007/BF00255786.
The effect of ventilatory frequency of high-frequency jet ventilation (HFJV) from 1 to 5 Hz, apart from changes in thoracic volume, on spontaneous breathing activity was studied in Yorkshire piglets under pentobarbital anesthesia. The highest PaCO2 at which the animals did not breathe against the ventilator (apnea point) was established either by changing minute volume of ventilation or by adding CO2 to the respiratory gas. The higher the apnea point, the higher the suppression of spontaneous breathing activity was assumed to be. If the apnea point was searched for by changing minute volume a progressive increase of suppression of spontaneous respiratory activity was found at ventilatory rates of 3 Hz or more, concomitantly with a rise in end-expiratory pressure (PEE). In case the tidal volume was kept constant, increase of ventilatory rate resulted in a tremendous increase of lung volume, together with considerably higher levels of PEE. When under these conditions the apnea point was searched for by adding CO2 to the respiratory gas a much higher CO2-drive was needed for spontaneous breathing and therefore a much stronger inhibition of spontaneous breathing was concluded. By placing the animals in a body box in which pressure could be varied, thoracic volume could be kept constant during HFJV. When thoracic volume was kept constant in this way a constant tidal volume at increasing jet frequencies resulted in only a slight increase in suppression of spontaneous breathing. We conclude that the increase in lung volume is a major factor in suppressing central respiratory activity during HFJV. Jet frequency by itself might be an additional suppressive factor.(ABSTRACT TRUNCATED AT 250 WORDS)
在戊巴比妥麻醉的约克郡仔猪中,研究了高频喷射通气(HFJV)频率从1至5Hz变化时,除胸廓容积改变外,对自主呼吸活动的影响。通过改变分钟通气量或向呼吸气体中添加二氧化碳来确定动物不抵抗呼吸机呼吸的最高动脉血二氧化碳分压(呼吸暂停点)。呼吸暂停点越高,自主呼吸活动的抑制作用越强。如果通过改变分钟通气量来寻找呼吸暂停点,发现在通气频率为3Hz或更高时,自主呼吸活动的抑制作用逐渐增强,同时呼气末压力(PEEP)升高。如果潮气量保持恒定,通气频率增加会导致肺容积大幅增加,同时PEEP水平显著升高。在这些条件下,通过向呼吸气体中添加二氧化碳来寻找呼吸暂停点时,自主呼吸需要更高的二氧化碳驱动,因此得出自主呼吸受到更强抑制的结论。将动物置于可改变压力的体箱中,在HFJV期间胸廓容积可保持恒定。当以这种方式保持胸廓容积恒定时,随着喷射频率增加,恒定的潮气量只会使自主呼吸抑制作用略有增加。我们得出结论,肺容积增加是HFJV期间抑制中枢呼吸活动的主要因素。喷射频率本身可能是一个额外的抑制因素。(摘要截短于250字)