Fiser W P, Friday C D, Read R C
Tex Rep Biol Med. 1979;39:235-45.
Pulmonary functional veno-arterial shunt determinations were made breathing 100% oxygen in thirty consecutive patients during thoracotomy with one-lung anesthesia. Initially, with both lungs ventilated (FiO2 100%), the mean shunt value was 18.1 +/- 1.2% (S.D.). With the collapse of one lung by deflation and surgical pneumothorax, the shunt rose to 36.0 +/- 1.5%. With time the value fell: 36.0 +/- 1.5% at five minutes, 30.3 +/- 1.4% at fifteen minutes, 30.3 +/- 1.4% at thirty minutes, 28.1 +/- 1.4% at sixty minutes, and 24.6 +/- 2.8% after two hours. This trend was significant at a p value of less than 0.001. This study for the first time documents in man the phenomenon of pulmonary circulatory adaptation to acute atelectasis.
在30例接受单肺麻醉开胸手术的患者中，于呼吸100%氧气时进行了肺功能静脉-动脉分流测定。最初，双肺通气时（吸入氧分数100%），平均分流值为18.1±1.2%（标准差）。随着一侧肺因萎陷和手术性气胸而塌陷，分流升至36.0±1.5%。随着时间推移，该值下降：5分钟时为36.0±1.5%，15分钟时为30.3±1.4%，30分钟时为30.3±1.4%，60分钟时为28.1±1.4%，2小时后为24.6±2.8%。这种趋势在p值小于0.001时具有显著性。本研究首次在人体中记录了肺循环对急性肺不张的适应现象。
