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[油酸诱导犬间质性肺水肿:呼气末正压通气与高频喷射叠加持续气道正压通气的比较]

[Oleic acid-induced interstitial lung edema in the dog: comparison of PEEP with high-frequency jet superimposed ZEEP ventilation].

作者信息

Schlag G, Redl H, Czech K

出版信息

Anaesthesist. 1985 Feb;34(2):65-71.

PMID:3985302
Abstract

Oleic acid (0.12 ml/kg) was used to induce pulmonary edema in 10 mongrel dogs. To treat the consequent hypoxaemia we used either positive end expiratory pressure (PEEP) ventilation (n = 5) or zero end expiratory pressure ventilation (ZEEP) plus additional high frequency jet support (n = 5). Hypoxaemia, which paralleled the dramatic increase in lung water, was significantly improved (aADO2) by PEEP but not by ZEEP plus jet. Also venous admixture was significantly lowered by PEEP only. Cardiac output and pulmonary arterial pressure in the two groups were not significantly different. This demonstrates that ZEEP plus jet is not superior to PEEP in the case of oleic acid induced edema, though we obtained good clinical results with the former system in the treatment of atelectasis. In addition, histological evaluation of the dog lungs showed emphysematous lung injury by the jet system, which indicates that such a jet system should be used with caution.

摘要

用油酸(0.12毫升/千克)诱导10只杂种犬发生肺水肿。为治疗随之而来的低氧血症,我们采用呼气末正压(PEEP)通气(n = 5)或呼气末零压通气(ZEEP)加额外高频喷射支持(n = 5)。与肺水显著增加同时出现的低氧血症,通过PEEP得到显著改善(肺泡-动脉血氧分压差),但ZEEP加喷射未使其改善。仅PEEP可显著降低静脉血掺杂。两组的心输出量和肺动脉压无显著差异。这表明在油酸诱导的水肿情况下,ZEEP加喷射并不优于PEEP,尽管我们使用前一种系统治疗肺不张取得了良好的临床效果。此外,对犬肺的组织学评估显示喷射系统导致肺气肿性肺损伤,这表明使用这种喷射系统应谨慎。

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