Zidulka A, Sylvester J T, Nadler S, Anthonisen N R
J Appl Physiol Respir Environ Exerc Physiol. 1979 Jan;46(1):8-13. doi: 10.1152/jappl.1979.46.1.8.
In anesthetized and paralyzed pigs in the left decubitus position we obstructed, at functional residual capacity (FRC), either the right middle and lower lobes, or a small posterior basal lung unit, and then passively inflated the unobstructed remaining lung. Measurements were made of alveolar pressure in the obstructed and unobstructed lung regions as well as of esophageal pressure. The tendency of the obstructed lung region to inflate as the remainder of the lung was inflated was assessed by an index (A), which was the end-inspiratory pressure difference between unobstructed and obstructed alveolar pressures, normalized by the change in elastic recoil of unobstructed lung. With the chest wall intact, inflation of unobstructed lung resulted in a tendency to inflate the obstructed regions. This tendency was abolished with the chest wall removed. In a second group of pigs with the basilar lung unit obstructed, the height of the unit was changed by turning a pig from right to left decubitus positions. In each position A was assessed with both spontaneous and positive pressure ventilation. The magnitude of A was found to vary directly with the magnitude of caudal diaphragmatic motion and was greatest with the lung unit dependent and with spontaneous ventilation. These results suggest that lung-chest wall interaction was a more important factor tending to preserve homogenous inflation than lung tissue interdependence.
在处于左侧卧位的麻醉和麻痹猪中,我们在功能残气量(FRC)时阻塞右中、下叶或一个小的后基底肺单位,然后被动扩张未阻塞的剩余肺组织。测量阻塞和未阻塞肺区域的肺泡压力以及食管压力。通过一个指数(A)评估阻塞肺区域随着肺的其余部分扩张而扩张的趋势,该指数是未阻塞和阻塞肺泡压力之间的吸气末压力差,通过未阻塞肺的弹性回缩变化进行归一化。在胸壁完整的情况下,未阻塞肺的扩张导致阻塞区域有扩张的趋势。去除胸壁后这种趋势消失。在第二组阻塞基底肺单位的猪中,通过将猪从右侧卧位转为左侧卧位来改变该肺单位的高度。在每个体位下,分别通过自主通气和正压通气评估指数A。发现指数A的大小与膈尾端运动的大小直接相关,并且在肺单位处于下垂位且为自主通气时最大。这些结果表明,肺与胸壁的相互作用比肺组织间的相互依存关系更重要,是趋向于维持均匀扩张的一个因素。