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[临床条件下Christiansen-Douglas-Haldane效应的体内检测]

[In vivo detection of the Christiansen-Douglas-Haldane effect in clinical conditions].

作者信息

Brandt L, Mertzlufft F O, Rudlof B, Dick W

机构信息

Klinik für Anaesthesiologie, Johannes Gutenberg-Universität Mainz.

出版信息

Anaesthesist. 1988 Aug;37(8):529-34.

PMID:3140689
Abstract

The Christiansen-Douglas-Haldane effect, also termed Haldane effect, describes the dependence of CO2 absorption by blood on the degree of hemoglobin oxygenation. Under the physiological condition of an "open" system between blood and alveolus, the arterial partial pressure of CO2 (paCO2; mmHg) must range below the mixed-venous (pvCO2; mmHg) value. During the nonphysiological situation of a "closed" system, e.g. hyperoxic apnea after adequate pre-oxygenation (O2 uptake with lack of CO2 delivery), paCO2 can assimilate to pvCO2 and even exceed it. The remainder has often been termed a "paradoxical phenomenon". It was the aim of this study to prove the Haldane effect in vivo in the "closed" system of hyperoxic apnea. Eighty patients (ASA II-IV, NYHA II-III) scheduled for coronary surgery gave written informed consent and were examined. Following the preparations for induction (venous and arterial cannulas, pulmonary artery catheter), they were pre-oxygenated with 6 l O2/min until induction of anesthesia was achieved. Pre-oxygenation was maintained actively/passively until intubation. At the onset and the end of intubation the arterial (a) and mixed-venous (v) blood gas status (pHa, pHv, saO2 and svO2 (%), paO2 and pvO2, paCO2 and pvCO2 were determined using the Corning 170 pH/blood gas analyzer and the Corning 2500 CO-oximeter. Statistical analysis of the data was based on Student's t-test for paired samples. Periods of apnoea ranged between 60 and 180 s. The data were allocated to three groups, depending on the duration of apnea: Group I: 60-100 s; Group II: 101-140 s; Group III: 141-180 s.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

克里斯蒂安森 - 道格拉斯 - 霍尔丹效应,也称为霍尔丹效应,描述了血液对二氧化碳的吸收与血红蛋白氧合程度之间的关系。在血液与肺泡之间“开放”系统的生理条件下,动脉血二氧化碳分压(paCO2;mmHg)必须低于混合静脉血(pvCO2;mmHg)的值。在“封闭”系统的非生理情况下,例如在充分预充氧(吸氧但无二氧化碳排出)后的高氧性呼吸暂停期间,paCO2可等同于pvCO2甚至超过它。其余情况常被称为“矛盾现象”。本研究的目的是在高氧性呼吸暂停的“封闭”系统中在体内证明霍尔丹效应。80例计划进行冠状动脉手术的患者(ASA II - IV级,NYHA II - III级)签署了书面知情同意书并接受了检查。在完成诱导准备(静脉和动脉插管、肺动脉导管)后,他们以6升/分钟的氧气进行预充氧,直至达到麻醉诱导。预充氧通过主动/被动方式维持至插管。在插管开始和结束时,使用康宁170型pH/血气分析仪和康宁2500型一氧化碳血氧计测定动脉(a)和混合静脉(v)血气状态(pHa、pHv、saO2和svO2(%)、paO2和pvO2、paCO2和pvCO2)。数据的统计分析基于配对样本的学生t检验。呼吸暂停时间在60至180秒之间。根据呼吸暂停持续时间,数据分为三组:第一组:60 - 100秒;第二组:1

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