Jiang K Y, Li A, Pan J, Zhu P F, He B B, Chen F M, Lian W K, Wang T Y, Wu Z Z
Burn Center, Southwestern Hospital, Third Military Medical College, CPLA, Chongqing, China.
Burns Incl Therm Inj. 1987 Oct;13(5):371-6. doi: 10.1016/0305-4179(87)90126-4.
The dynamic changes in blood gases in 34 dogs suffering severe steam inhalation injury were studied during the first 14 days post-burn to determine the effects of inhalation injury on lung function. Nineteen dogs received only severe steam inhalation injury, while 15 other dogs received both 30 per cent total body surface area (TBSA) deep burns and steam inhalation injury. The results showed marked reductions of PaO2, PaCO2, AB, SBE, T-CO2, SB, BBp, pHNR and SatO2 (P less than 0.05 approximately 0.01), whereas the P(A-a)O2 increased (P less than 0.05 approximately 0.01) within week 1 post-burn in both groups. These data suggest that the injured animals were suffering from hypoxaemia and respiratory alkalosis induced by disturbance of the gas-exchange function of the lungs. There was also metabolic acidosis, which was closely related to high fever, excessive catabolism, and particularly to hypoxaemia in week 1 post-burn. If the animals survived through the critical period (1-7 days post-burn), most of the abnormal gas parameters then gradually returned to the pre-burn levels. It is clear, therefore, that blood gas monitoring in patients with inhalation injury is not only of diagnostic importance but also of prognostic value.
对34只遭受严重蒸汽吸入性损伤的犬在烧伤后的前14天内进行血气动态变化研究，以确定吸入性损伤对肺功能的影响。19只犬仅遭受严重蒸汽吸入性损伤，而另外15只犬同时遭受30%体表面积（TBSA）的深度烧伤和蒸汽吸入性损伤。结果显示，两组犬在烧伤后第1周内，动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、实际碳酸氢盐（AB）、标准碱剩余（SBE）、总二氧化碳含量（T-CO2）、标准碳酸氢盐（SB）、血浆缓冲碱（BBp）、pH值非呼吸影响值（pHNR）和血氧饱和度（SatO2）均显著降低（P小于0.05至0.01），而肺泡 - 动脉血氧分压差（P(A-a)O2）升高（P小于0.05至0.01）。这些数据表明，受伤动物存在因肺气体交换功能紊乱导致的低氧血症和呼吸性碱中毒。同时还存在代谢性酸中毒，这与高热、过度分解代谢，尤其是烧伤后第1周的低氧血症密切相关。如果动物能度过危险期（烧伤后1 - 7天），大多数异常气体参数随后会逐渐恢复到烧伤前水平。因此，显然吸入性损伤患者的血气监测不仅具有诊断意义，而且具有预后价值。
