Sutherland G R, Park J, Proudfoot A T
Clin Toxicol. 1977;11(4):403-12. doi: 10.3109/15563657708988203.
Forty-two adults in deep coma due to uncomplicated overdosage with barbiturates or tricyclic antidepressants were studied to determine the effects of the drugs and the depth of coma on ventilation and acid-base balance. All the patients were breathing spontaneously. The usual acid-base disturbance was a mixed respiratory and metabolic acidosis. No differences in effects of barbiturates and tricyclic antidepressants could be demonstrated in either grade of coma studied. Patients who were completely unresponsive to painful stimuli were significantly more acidemic (arterial [H+] 51.4 nmole/liter c.f. 44.4 mole/liter) and hypoxic (PaO2 6.6 kPa c.f. 10.5 kPa) than those who showed a minimal response to pain. These findings could not be explained by differences in alveolar ventilation, and it is suggested that they are due to ventilation/perfusion imbalance.
对42名因单纯过量服用巴比妥类药物或三环类抗抑郁药而处于深度昏迷的成年人进行了研究，以确定药物及昏迷深度对通气和酸碱平衡的影响。所有患者均自主呼吸。常见的酸碱紊乱为混合性呼吸性和代谢性酸中毒。在所研究的任一昏迷程度中，均未发现巴比妥类药物和三环类抗抑郁药的作用存在差异。对疼痛刺激完全无反应的患者比那些对疼痛有轻微反应的患者明显更酸血症（动脉血[H⁺] 51.4纳摩尔/升对比44.4纳摩尔/升）和低氧（动脉血氧分压6.6千帕对比10.5千帕）。这些发现无法用肺泡通气的差异来解释，提示它们是由于通气/灌注失衡所致。
