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间接测量肺不张时的加速度和吸入氧浓度的作用。

Indirect Measurements of Acceleration Atelectasis and the Role of Inspired Oxygen Concentrations.

出版信息

Aerosp Med Hum Perform. 2021 Oct 1;92(10):780-785. doi: 10.3357/AMHP.5859.2021.

Abstract

A growing number of symptom reports suggestive of acceleration atelectasis in fast jet aircrew have raised the question as to whether traditional guidelines on inspired gas composition remain valid. The aim of this study was to assess the effects of inspired O₂ concentration on the development of acceleration atelectasis when wearing modern anti-G garments. There were 14 nonaircrew subjects who completed 5 centrifuge exposures to +5 G lasting 90 s. During exposures subjects breathed a gas mixture containing 21, 35, 45, 60, or 75% O₂. To assess the extent of atelectasis post-G, forced inspiratory vital capacity (FIVC), regional FIVC (EIT), shunt, respiratory resistance, reactance, and compliance and peripheral O₂ saturation during a hypoxic exposure were measured. Compared with baseline, FIVC was not statistically significantly altered. EIT was 14.4% lower after the 75% O₂ exposure only with a greater symptom reporting with higher FO₂ in some individuals. A significantly greater shunt (3>6%) followed the 60 and 75% O₂ exposures. O₂ concentration during G had no effect on respiratory resistance, reactance, compliance, or hypoxemia. There is evidence of mild acceleration atelectasis present when breathing 60% O₂, particularly in susceptible individuals, with 75% O₂ causing more obvious physiological compromise. An inspired oxygen concentration of <60% will prevent the majority of individuals from developing acceleration atelectasis. .

摘要

越来越多的症状报告表明,在快速喷气式飞机机组人员中,加速度性肺不张的发生率有所增加,这使得人们开始质疑传统的吸入气体成分指南是否仍然有效。本研究旨在评估在穿着现代抗 G 装备时,吸入氧气浓度对加速度性肺不张发展的影响。共有 14 名非机组人员完成了 5 次持续 90 秒的+5 G 离心机暴露。在暴露过程中,受试者呼吸含有 21%、35%、45%、60%或 75%氧气的混合气体。为了评估 G 后肺不张的程度,测量了吸气峰容量(FIVC)、区域吸气峰容量(EIT)、分流、呼吸阻力、电抗和顺应性以及缺氧暴露期间的外周血氧饱和度。与基线相比,FIVC 没有统计学上的显著变化。仅在 75%氧气暴露后,EIT 降低了 14.4%,并且在一些个体中,随着 FO₂的升高,症状报告更多。60%和 75%氧气暴露后,分流明显增加(3>6%)。G 期间的氧气浓度对呼吸阻力、电抗、顺应性或低氧血症没有影响。当呼吸 60%氧气时,有证据表明存在轻度加速度性肺不张,尤其是在易感个体中,而 75%氧气会导致更明显的生理损伤。吸入氧气浓度<60%将防止大多数个体发生加速度性肺不张。

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