Larsson A, Jonmarker C, Jögi P, Werner O
Can J Anaesth. 1987 Mar;34(2):141-5. doi: 10.1007/BF03015331.
Functional residual capacity (FRC), breath-by-breath compliance of the respiratory system (Crs) and arterial oxygen tension (PaO2) were measured in ten children, two months to nine years of age, during anaesthesia for surgical correction of patent ductus arteriosus or coarctation of the aorta. The children were mechanically ventilated with halothane, nitrous oxide and oxygen. FIO2 was kept constant in each child. After induction of anaesthesia, FRC was 17 +/- 7 ml X kg-1 (mean +/- 1 SD), corresponding to 60 +/- 22 per cent of a predicted awake value. FRC increased to 21 +/- 8 ml X kg-1 (p = 0.0005) when the child was turned to its right side and decreased to 13 +/- 5 ml X kg-1 (p = 0.0003) when the pleura was opened. No significant change in Crs or PaO2 occurred during these manoeuvres. Retraction of the upper lung to visualize the great vessels caused a significant decrease in FRC, Crs, and PaO2. The lowest PaO2 observed during this stage was 70.0 mmHg. After surgery FRC and PaO2 were about the same as before surgery while Crs had decreased from 0.87 +/- 0.18 preoperatively to 0.64 +/- 0.15 ml X cmH2O-1 X kg-1 (p = 0.0069). This study shows that FRC increases when mechanically ventilated children are placed in the lateral position, and that thoracotomy is associated with marked changes in FRC, Crs and PaO2.
在10名年龄从2个月至9岁的儿童接受动脉导管未闭或主动脉缩窄手术矫正麻醉期间，测量了功能残气量（FRC）、呼吸系统逐次呼吸顺应性（Crs）和动脉血氧分压（PaO₂）。这些儿童使用氟烷、氧化亚氮和氧气进行机械通气。每个儿童的吸入氧分数（FIO₂）保持恒定。麻醉诱导后，FRC为17±7 ml·kg⁻¹（平均值±1标准差），相当于预计清醒值的60±22%。当患儿转为右侧卧位时，FRC增加至21±8 ml·kg⁻¹（p = 0.0005），而当胸膜打开时，FRC降至13±5 ml·kg⁻¹（p = 0.0003）。在这些操作过程中，Crs或PaO₂无显著变化。上肺回缩以显露大血管导致FRC、Crs和PaO₂显著下降。在此阶段观察到的最低PaO₂为70.0 mmHg。术后FRC和PaO₂与术前大致相同，而Crs从术前的0.87±0.18降至0.64±0.15 ml·cmH₂O⁻¹·kg⁻¹（p = 0.0069）。本研究表明，机械通气的儿童处于侧卧位时FRC增加，开胸手术与FRC、Crs和PaO₂的显著变化有关。
