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麻醉状态下人体对阻力负荷的即时反应。

Immediate response to resistive loading in anesthetized humans.

作者信息

Zin W A, Behrakis P K, Luijendijk S C, Higgs B D, Baydur A, Böddener A, Milic-Emili J

出版信息

J Appl Physiol (1985). 1986 Feb;60(2):506-12. doi: 10.1152/jappl.1986.60.2.506.

Abstract

In eight spontaneously breathing anesthetized subjects (halothane: approximately 1 minimal alveolar concn; 70% N2O-30% O2), we determined 1) the inspiratory driving pressure by analysis of the pressure developed at the airway opening (Poao) during inspiratory efforts against airways occluded at end expiration; 2) the active inspiratory impedance; and 3) the immediate (first loaded breath) response to added inspiratory resistive loads (delta R). Based on these data we made model predictions of the immediate tidal volume response to delta R. Such predictions closely fitted the experimental results. The present investigation indicates that 1) in halothane-anesthetized humans the shape of the Poao wave differs from that in anesthetized animals, 2) the immediate response to delta R is not associated with appreciable changes in intensity, shape, and timing of inspiratory neural drive but depends mainly on intrinsic (nonneural) mechanisms; 3) the flow-dependent resistance of endotracheal tubes must be taken into account in studies dealing with increased neuromuscular drive in intubated subjects; and 4) in anesthetized humans Poao reflects the driving pressure available to produce the breathing movements.

摘要

在八名自主呼吸的麻醉受试者(氟烷:约1个最低肺泡浓度;70%氧化亚氮 - 30%氧气)中,我们测定了:1)通过分析呼气末气道阻塞时吸气努力过程中气道开口处产生的压力(Poao)来确定吸气驱动压力;2)主动吸气阻抗;3)对增加的吸气阻力负荷(δR)的即时(首次加载呼吸)反应。基于这些数据,我们对δR引起的即时潮气量反应进行了模型预测。这些预测与实验结果密切相符。本研究表明:1)在氟烷麻醉的人体中,Poao波的形状与麻醉动物不同;2)对δR的即时反应与吸气神经驱动的强度、形状和时间的明显变化无关,主要取决于内在(非神经)机制;3)在研究插管受试者神经肌肉驱动增加时,必须考虑气管导管的流量依赖性阻力;4)在麻醉人体中,Poao反映了产生呼吸运动的可用驱动压力。

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