Stock M C, Downs J B, Betts R K, Frolicher D A, Howie M B, Tallman R D
Department of Anesthesiology, College of Medicine, Ohio State University, Columbus.
Am Rev Respir Dis. 1988 Apr;137(4):790-5. doi: 10.1164/ajrccm/137.4.790.
Acute lung injury causes a restrictive pulmonary defect, decreases lung compliance, and increases the work of breathing. We wished to determine the oxygen cost of the increased elastic work of breathing associated with acute lung injury. Extracorporeal venous circulation with a membrane lung was used to extract CO2 and to induce apnea in 14 anesthetized pigs. Data were collected during 4 experimental states: during spontaneous ventilation and apnea when the animals' lungs were normal, and after acute lung injury developed because of oleic acid administration. Acute lung injury decreased lung compliance from 101 +/- 79 (mean +/- SD) to 52 +/- 25 ml/cm H2O (p less than 0.04), and increased the elastic work of breathing from 700 +/- 590 to 1,060 +/- 630 ml.cm H2O (p = 0.01). During spontaneous ventilation, the increases in total O2 consumption and the O2 cost of breathing caused by acute lung injury were sufficiently small as to be undetectable, and, therefore, less than 3 to 4% of basal O2 consumption despite markedly increased elastic work and ventilatory power requirements. The increase in O2 consumption imposed by acute lung injury was small enough (less than 3 to 4% of total O2 consumption) that it appears to be clinically insignificant.
急性肺损伤可导致限制性肺功能缺陷，降低肺顺应性，并增加呼吸功。我们希望确定与急性肺损伤相关的呼吸弹性功增加所产生的氧耗。使用带有膜肺的体外静脉循环来提取二氧化碳并诱导14只麻醉猪呼吸暂停。在4种实验状态下收集数据：动物肺正常时的自主通气和呼吸暂停期间，以及因给予油酸而发生急性肺损伤后。急性肺损伤使肺顺应性从101±79（平均值±标准差）降至52±25ml/cm H₂O（p<0.04），并使呼吸弹性功从700±590增加至1060±630ml·cm H₂O（p = 0.01）。在自主通气期间，急性肺损伤导致的总氧耗增加和呼吸氧耗增加非常小，以至于无法检测到，因此，尽管弹性功和通气功率需求明显增加，但仍低于基础氧耗的3%至4%。急性肺损伤所导致的氧耗增加足够小（低于总氧耗的3%至4%），以至于在临床上似乎无显著意义。
