Bates J H, Rossi A, Milic-Emili J
J Appl Physiol (1985). 1985 Jun;58(6):1840-8. doi: 10.1152/jappl.1985.58.6.1840.
For a respiratory system with constant compliance and resistance a constant flow can occur during part or all of inspiration in two situations: when the flow is constrained to be constant throughout inspiration, such as is the case with some mechanical ventilators, and when the applied pressure is a ramp (i.e., increasing constantly with time), which may occur during mechanical ventilation and spontaneous breathing. After initial transients in pressure and flow, respectively, have decayed away both situations result in linear volume-time and pressure-time relationships. The slope of the corresponding pressure-volume line then yields an estimate of the total compliance of the respiratory system, and the intercept, divided by the constant flow, provides the total resistance. We have shown theoretically that, for a model composed of two compartments in parallel, the total compliance is the same as the static compliance and equals the sum of the compliances of the two compartments. Furthermore, this compliance is independent of the breathing frequency. However, the total resistance is, in general, a function of both the resistances and the compliances. When the time constants of the two compartments are equal the total resistance assumes its minimum value and becomes independent of the compliances. This minimum value of resistance can be obtained, regardless of the time constants, by dividing the immediate drop in airway opening pressure, obtained after occluding during steady state inspiration, by the inspiratory flow.
对于具有恒定顺应性和阻力的呼吸系统,在部分或全部吸气过程中,在两种情况下可出现恒定流量:一是在整个吸气过程中流量被限制为恒定,某些机械通气时就是这种情况;二是施加的压力呈斜坡式(即随时间持续增加),这在机械通气和自主呼吸过程中都可能发生。在压力和流量的初始瞬态分别衰减后,这两种情况都会导致线性的容积 - 时间和压力 - 时间关系。相应压力 - 容积线的斜率进而得出呼吸系统总顺应性的估计值,截距除以恒定流量则得出总阻力。我们从理论上表明,对于由两个并联腔室组成的模型,总顺应性与静态顺应性相同,且等于两个腔室顺应性之和。此外,这种顺应性与呼吸频率无关。然而,总阻力通常是阻力和顺应性两者的函数。当两个腔室的时间常数相等时,总阻力取其最小值且变得与顺应性无关。无论时间常数如何,通过将稳态吸气时阻塞后气道开口压力的即时下降值除以吸气流量,均可获得该最小阻力值。