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氧化亚氮-氟烷麻醉期间儿童对二氧化碳的通气反应。

Ventilatory responses to carbon dioxide in children during nitrous oxide-halothane anaesthesia.

作者信息

Murat I, Chaussain M, Saint-Maurice C

出版信息

Br J Anaesth. 1985 Dec;57(12):1197-203. doi: 10.1093/bja/57.12.1197.

Abstract

The ventilatory response to carbon dioxide was studied in 12 unpremedicated children, aged 20-68 months, weighing between 10 and 20 kg, under nitrous oxide-halothane anaesthesia. Tidal volume (VT) and end-tidal carbon dioxide tension (PE'CO2) were continuously measured by pneumotachograph and capnograph. Minute ventilation (VE), respiratory rate (f), mean inspiratory flow (Vl) and effective inspiratory cycle (Tl/Ttot) were calculated during anaesthesia at three different inspired halothane concentrations (0.5, 1 and 1.5%). The ventilatory response to carbon dioxide was determined by relating the increase in ventilation during exposure to 2% carbon dioxide to the change in end-tidal carbon dioxide concentration. When the inspired concentration of halothane increased, there were significant decreases in VE, VT, Vl, and a significant increase in PE' CO2. The slope of the carbon dioxide response under light nitrous oxide-halothane anaesthesia (0.5% halothane) was relatively flat (18.64 ml min-1 kg-1 mm Hg-1) when compared with the mean values published for anaesthetized adults, children or neonates. When the inspired concentration of halothane was increased, the slope decreased significantly (39% of initial value at 1% inspired halothane, 26% at 1.5%). The addition of carbon dioxide produced significant increases in VE, VT and Vl but no change in respiratory rate. No statistical difference was observed in the slope of carbon dioxide response between the initial and "control" periods which were measured at the same inspired halothane concentration (0.5%).

摘要

在氧化亚氮-氟烷麻醉下,对12名未用术前药的儿童进行了二氧化碳通气反应研究。这些儿童年龄在20至68个月之间,体重10至20千克。通过呼吸流速仪和二氧化碳监测仪连续测量潮气量(VT)和呼气末二氧化碳分压(PE'CO2)。在三种不同的吸入氟烷浓度(0.5%、1%和1.5%)的麻醉过程中,计算分钟通气量(VE)、呼吸频率(f)、平均吸气流量(Vl)和有效吸气周期(Tl/Ttot)。通过将暴露于2%二氧化碳期间通气量的增加与呼气末二氧化碳浓度的变化相关联,来确定对二氧化碳的通气反应。当吸入氟烷浓度增加时,VE、VT、Vl显著降低,而PE'CO2显著升高。与已发表的麻醉成人、儿童或新生儿的平均值相比,在轻度氧化亚氮-氟烷麻醉(0.5%氟烷)下,二氧化碳反应斜率相对平缓(18.64毫升·分钟-1·千克-1·毫米汞柱-1)。当吸入氟烷浓度增加时,斜率显著降低(吸入1%氟烷时为初始值的39%,吸入1.5%时为26%)。添加二氧化碳使VE、VT和Vl显著增加,但呼吸频率无变化。在相同吸入氟烷浓度(0.5%)下测量的初始期和“对照”期之间,二氧化碳反应斜率未观察到统计学差异。

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