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持续气道正压通气对烟雾吸入伤的治疗有益。

Continuous positive airway pressure is beneficial in treatment of smoke inhalation.

作者信息

Davies L K, Poulton T J, Modell J H

出版信息

Crit Care Med. 1983 Sep;11(9):726-9. doi: 10.1097/00003246-198309000-00011.

Abstract

This study demonstrates that continuous positive airway pressure (CPAP) improves pulmonary function after smoke inhalation by dogs. Sixteen dogs were anesthetized with iv sodium pentobarbital. Arterial and mixed venous blood gas tensions; carboxyhemoglobin concentration (COHgb); mean systemic arterial (MAP), mean pulmonary arterial (MPAP), and pulmonary arterial wedge (WP) pressures; heart (HR) and respiratory (f) rates; cardiac output (CO); and airway pressure (Paw) were measured. Intrapulmonary physiologic shunt (Qsp/Qt) and pulmonary (PVR) and systemic (SVR) vascular resistances were calculated. The animals then breathed an aerosol of smoke and were divided randomly into 2 groups. The treatment group breathed spontaneously on 8-torr CPAP whereas the control group continued to breathe spontaneously at ambient pressure. After inhalation of smoke, Qsp/Qt, MPAP, PVR, COHgb, HR, and f rose, whereas PaO2 and MAP fell in untreated animals. When CPAP was applied, PaO2 and Qsp/Qt returned nearly to baseline values. Mean f also was significantly lower in the treated animals. We found that the early institution of CPAP improves oxygen exchange in the lungs after the inhalation of smoke.

摘要

本研究表明,持续气道正压通气(CPAP)可改善犬吸入烟雾后的肺功能。16只犬用静脉注射戊巴比妥钠麻醉。测量动脉血和混合静脉血的血气张力、碳氧血红蛋白浓度(COHgb)、平均体动脉压(MAP)、平均肺动脉压(MPAP)和肺动脉楔压(WP)、心率(HR)和呼吸频率(f)、心输出量(CO)以及气道压力(Paw)。计算肺内生理分流(Qsp/Qt)以及肺血管阻力(PVR)和体循环血管阻力(SVR)。然后,动物吸入烟雾气溶胶,并随机分为两组。治疗组在8托的CPAP下自主呼吸,而对照组在常压下继续自主呼吸。吸入烟雾后,未治疗动物的Qsp/Qt、MPAP、PVR、COHgb、HR和f升高,而PaO2和MAP下降。应用CPAP时,PaO2和Qsp/Qt几乎恢复到基线值。治疗组动物的平均呼吸频率也显著降低。我们发现,早期应用CPAP可改善烟雾吸入后肺内的氧交换。

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