Wang Junkang, Cui Qian, Huang Yuqing, Zhang Hongliang, Wang Jing, Guo Chengyu, Feng Cong, Pan Fei, Li Tanshi
Medical School of Chinese PLA, Beijing 100039, China.
Department of Emergency, the First Medical Centre, Chinese PLA General Hospital, Beijing 100039, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Dec;33(12):1466-1470. doi: 10.3760/cma.j.cn121430-20210809-01154.
To observe the changes of arterial blood gas indexes in pigs with the free-field primary blast lung injury (PBLI) model, and to explore the value of arterial blood gas indexes in predicting moderate to severe PBLI.
Nine adult healthy Landrace pigs were selected to construct the pig free-field PBLI model. Arterial blood samples were taken 15 minutes before the explosion (before injury) and 10, 30, 60, 120, and 180 minutes after the explosion (after injury). Arterial blood gas indexes and pulse oxygen saturation (SpO) were measured, compare the changes of blood gas analysis indexes and SpO levels at different time points, and observe the changes of gross injury scores and pathological injury scores of lung tissue. Analyze the correlation between the blood gas indicators.
As time prolonged, at each time point, pH, arterial partial pressure of oxygen (PaO), and SpO were lower than those before the injury, and blood lactic acid (Lac) and arterial partial pressure of carbon dioxide (PaCO) were higher than those before the injury. Compared with that before the injury, the pH value in the blood decreased significantly 10 minutes after the injury (7.39±0.06 vs. 7.46±0.02, P < 0.05), and the Lac increased significantly (mmol/L: 3.61±2.89 vs. 1.10±0.28, P < 0.05), and lasts until 180 minutes after injury (pH value: 7.37±0.07 vs. 7.46±0.02, Lac (mmol/L): 2.40±0.79 vs. 1.10±0.28, both P < 0.05); while PaO and SpO decreased significantly at 180 minutes after injury [PaO (mmHg, 1 mmHg = 0.133 kPa): 59.40±10.94 vs. 74.81±9.39, P < 0.05; SpO: 0.75±0.11 vs. 0.89±0.08, P < 0.05], PaCO increased significantly (mmHg: 56.17±5.38 vs. 48.42±4.93, P < 0.05). Correlation analysis showed that the gross injury score of lung blast injury animals was positively correlated with the pathological injury score (r = 0.866, P = 0.005); PaO and SpO were positively correlated (r = 0.703, P = 0.000); pH value and Lac were negative Correlation (r = -0.400, P = 0.006); pH value is negatively correlated with PaCO (r = -0.844, P = 0.000).
This study successfully established a large mammalian free-field PBLI model, arterial blood gas analysis is helpful for the early diagnosis of PBLI, whether SpO can be used to evaluate the severity of lung injury remains to be further verified.
观察自由场原发性冲击伤肺损伤(PBLI)模型猪动脉血气指标的变化,探讨动脉血气指标在预测中重度PBLI中的价值。
选取9只成年健康长白猪构建猪自由场PBLI模型。于爆炸前15分钟(伤前)及爆炸后10、30、60、120和180分钟(伤后)采集动脉血样本。测定动脉血气指标及脉搏血氧饱和度(SpO),比较不同时间点血气分析指标及SpO水平的变化,并观察肺组织大体损伤评分及病理损伤评分的变化。分析血气指标之间的相关性。
随着时间延长,各时间点的pH值、动脉血氧分压(PaO)及SpO均低于伤前,血乳酸(Lac)及动脉血二氧化碳分压(PaCO)均高于伤前。与伤前比较,伤后10分钟血液pH值显著降低(7.39±0.06比7.46±0.02,P<0.05),Lac显著升高(mmol/L:3.61±2.89比1.10±0.28,P<0.05),并持续至伤后180分钟(pH值:7.37±0.07比7.46±0.02,Lac(mmol/L):2.40±0.79比1.10±0.28,均P<0.05);而伤后180分钟PaO及SpO显著降低[PaO(mmHg,1mmHg = 0.133kPa):59.40±10.94比74.81±9.39,P<0.05;SpO:0.75±0.11比0.89±0.08,P<0.05],PaCO显著升高(mmHg:56.17±5.38比48.42±4.93,P<0.05)。相关性分析显示,肺冲击伤动物的大体损伤评分与病理损伤评分呈正相关(r = 0.866,P = 0.005);PaO与SpO呈正相关(r = 0.703,P = 0.000);pH值与Lac呈负相关(r = -0.400,P = 0.006);pH值与PaCO呈负相关(r = -0.844,P = 0.000)。
本研究成功建立了大型哺乳动物自由场PBLI模型,动脉血气分析有助于PBLI的早期诊断,SpO能否用于评估肺损伤严重程度尚有待进一步验证。