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犬类热射病模型中的高频喷射通气冷却

High-frequency jet ventilation cooling in a canine hyperthermia model.

作者信息

Barker W J, Amsterdam J T, Syverud S A, Hedges J R, Huff J S

出版信息

Ann Emerg Med. 1986 Jun;15(6):680-4. doi: 10.1016/s0196-0644(86)80425-5.

DOI:10.1016/s0196-0644(86)80425-5
PMID:3706859
Abstract

A study was undertaken to evaluate high-frequency jet ventilation (HFJV) as an adjunct for the treatment of heatstroke. Eleven mongrel dogs were anesthetized, shaved, and externally heated until core temperature reached 43 C (109.4 F). Control animals (n = 6) were cooled passively in room air. Treatment animals (n = 5) were cooled with the addition of HFJV using a flow-interrupter, high-frequency jet ventilator with a rate of 200, a driving pressure of 40 psi, and an inspiratory to expiratory ratio of .5 to deliver room air. Temperatures were measured in brain, pulmonary artery, rectum, and subcutaneous tissue of the chest wall. Serial arterial blood gases, cardiac outputs, and mean arterial pressures were measured at baseline, maximal heating, and at .5, 1, 2, and 12 hours after heating. Animals were sacrificed 12 hours after heatstroke induction. Cooling rates for brain, pulmonary artery, and rectum achieved in the HFJV group were 1.7 times faster than those for the control group (P less than .05), although slower than previously reported cooling rates with gastric and peritoneal lavage. A higher PO2, a lower PCO2, and a more physiologic pH was maintained in the HFJV group than in the control group at 30 and 60 minutes after onset of cooling (P less than .05). Gross and histopathologic examination showed characteristic changes of heatstroke in both groups; no deleterious findings could be attributed to the use of HFJV itself. HFJV warrants clinical investigation as an adjunct for treatment of hyperthermia.

摘要

开展了一项研究以评估高频喷射通气(HFJV)作为中暑治疗辅助手段的效果。11只杂种犬被麻醉、剃毛并进行外部加热,直至核心体温达到43℃(109.4°F)。对照组动物(n = 6)在室内空气中被动降温。治疗组动物(n = 5)在使用流量中断器的高频喷射通气辅助下进行降温,该高频喷射通气机频率为200、驱动压力为40 psi、吸气与呼气比为0.5,输送室内空气。在脑、肺动脉、直肠和胸壁皮下组织测量温度。在基线、最大加热时以及加热后0.5、1、2和12小时测量系列动脉血气、心输出量和平均动脉压。中暑诱导12小时后处死动物。HFJV组脑、肺动脉和直肠的降温速率比对照组快1.7倍(P小于0.05),尽管比先前报道的胃灌洗和腹腔灌洗的降温速率慢。降温开始后30和60分钟时,HFJV组比对照组维持了更高的PO2、更低的PCO2和更生理的pH值(P小于0.05)。大体和组织病理学检查显示两组均有中暑的特征性变化;未发现可归因于使用HFJV本身的有害结果。HFJV作为高热治疗的辅助手段值得进行临床研究。

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