Hayek Z, Peliowski A, Ryan C A, Jones R, Finer N N
Am Rev Respir Dis. 1986 Apr;133(4):630-4. doi: 10.1164/arrd.1986.133.4.630.
In an effort to develop a method of assisted ventilation that would avoid endotracheal intubation, 11 anesthetized, paralyzed, nonintubated adult mongrel cats with normal lungs were externally oscillated by means of a thoracoabdominal chamber connected to a vacuum source and a high frequency oscillator. Chamber pressure was adjusted to the desired negative pressure using the vacuum source, and the animal was then oscillated above and below this pressure. The lowest PaCO2 and AaPO2 were observed at 3 Hz. Tidal volume (VT) fell (p less than 0.001) with increases in frequency, and lung volume (VL) rose with increased negative chamber pressure (p less than 0.001). In 11 additional tracheostomized cats, a stiff lung was created by repeated saline lung lavage. External high frequency oscillation (EHFO), using pressures comparable to those used for conventional mechanical ventilation (CMV), was associated with a significant increase in PaO2 (p less than 0.001), and a significant fall in AaPO2 (p less than 0.01) compared with that during CMV. Lung volume was significantly higher during EHFO (p less than 0.001) and, as in the normal lung, VT fell with increasing frequencies to 15 Hz (p less than 0.001). There were no significant frequency-dependent variations in gas exchange or VL. An increasingly negative mean chamber pressure was associated with a significant increase in PaO2 (p less than 0.05) and VL(p less than 0.005) and a significant decrease in PaCO2 (p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
为了开发一种避免气管插管的辅助通气方法,对11只肺部正常、已麻醉、瘫痪且未插管的成年杂种猫进行了实验。通过连接到真空源和高频振荡器的胸腹腔室对其进行外部振荡。使用真空源将腔室压力调节到所需的负压,然后使动物在该压力上下振荡。在3Hz时观察到最低的动脉血二氧化碳分压(PaCO2)和肺泡-动脉血氧分压差(AaPO2)。潮气量(VT)随频率增加而下降(p<0.001),肺容积(VL)随腔室负压增加而上升(p<0.001)。在另外11只做了气管切开术的猫中,通过反复盐水肺灌洗造成肺僵硬。与传统机械通气(CMV)相比,使用与CMV相当的压力进行外部高频振荡(EHFO)时,动脉血氧分压(PaO2)显著升高(p<0.001),AaPO2显著下降(p<0.01)。EHFO期间肺容积显著更高(p<0.001),并且与正常肺一样,VT随频率增加至15Hz而下降(p<0.001)。气体交换或VL没有明显的频率依赖性变化。平均腔室压力越来越负与PaO2显著升高(p<0.05)、VL显著升高(p<0.005)以及PaCO2显著降低(p<0.025)相关。(摘要截短于250字)