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缺氧与高碳酸血症对麻醉大鼠通气、潮气量及呼吸频率的相互作用

Interaction of hypoxia and hypercapnia on ventilation, tidal volume and respiratory frequency in the anaesthetized rat.

作者信息

Cragg P A, Drysdale D B

出版信息

J Physiol. 1983 Aug;341:477-93. doi: 10.1113/jphysiol.1983.sp014818.

DOI:10.1113/jphysiol.1983.sp014818
PMID:6413681
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1195573/
Abstract
  1. Ventilation ( V(E)), tidal volume (V(T)), respiratory frequency (f) and arterial and end-tidal gas tensions were measured in seventy-one tracheostomized New Zealand white rats ( approximately 405 g) anaesthetized with an initial dose of pentobarbitone followed by repeated small doses to ensure that a weak limb-withdrawal reflex remained.2. O(2) consumption (1.2 ml (s.t.p.d.) min(-1) 100 g(-1)), CO(2) production (1.0 ml (s.t.p.d.) min(-1) 100 g(-1)), heart rate (357 min(-1)), V(E) (43 ml min(-1) 100 g(-1)), P(a,CO2) (34 mmHg) and P(a,O2) (84 mmHg) in the control periods did not change significantly during the course of the experiment.3. Inspirates of 21% O(2) with 2-10% CO(2), 15, 10 or 7.5% O(2) with either no or sufficient CO(2) to maintain normocapnia and 15 or 10% O(2) with 4, 6 or 8% CO(2) were tested. Steady-state responses were measured after 2 min of exposure.4. Hypoxic-hypercapnic interaction on V(E), V(T) and f determined by a three-inspirate test ((i) hypoxia alone, (ii) hypercapnia and (iii) these hypoxic and hypercapnic levels combined) yielded various conclusions depending on the level of asphyxia examined. Essentially, the milder the asphyxia the more the interaction appeared additive or even multiplicative and the stronger the asphyxia the more the interaction appeared occlusive. However, this test is unsuitable for accurately showing interactions because the P(a,O2) achieved in asphyxia was higher than in hypoxia and the asphyxial P(a,CO2) was lower than in hypercapnia.5. For isoxic conditions (P(a,O2) = 97, 77 and 51 mmHg), V(E) and V(T) were related linearly to P(a,CO2) whilst f was related hyperbolically with convexity upwards (P(a,O2) 97 mmHg) or downwards (P(a,O2) 77 and 51 mmHg).6. For isocapnic conditions (P(a,CO2) = 33, 40 and 48 mmHg), V(E) and V(T) were inversely related to P(a,O2) with a hyperbolic curve (convexity downwards) whilst f was inversely and linearly related (P(a,CO2) 33 mmHg) or constant (P(a,CO2) 40 and 48 mmHg).7. Multivariate analyses showed that the hypoxic-hypercapnic interaction was additive for V(T) but occlusive for V(E) and f and the occlusion was more severe in the latter. This was illustrated graphically for the variable plotted against P(a,CO2) or P(a,O2) as parallel shifts in regression lines for V(T), flatter regression lines for V(E) during asphyxia and a virtually constant f during asphyxia.8. V(E) responses and sensitivities to hypoxia and hypercapnia, the shape of V(E), V(T) and f regression lines against P(a,O2) and P(a,CO2) and the type of hypoxic-hypercapnic interaction on each variable in the rat were compared with other species.9. Possible causes of the occlusive hypoxic-hypercapnic interaction in the rat were considered.
摘要
  1. 对71只新西兰大白鼠(约405克)进行气管切开,先用戊巴比妥钠初始剂量麻醉,随后多次给予小剂量以确保保留微弱的肢体退缩反射,在此期间测量通气量(V(E))、潮气量(V(T))、呼吸频率(f)以及动脉和呼气末气体张力。

  2. 在实验过程中,对照期的耗氧量(1.2毫升(标准温度和压力下干气体体积)每分钟每100克)、二氧化碳产生量(1.0毫升(标准温度和压力下干气体体积)每分钟每100克)、心率(357次每分钟)、V(E)(43毫升每分钟每100克)、动脉血二氧化碳分压(P(a,CO2))(34毫米汞柱)和动脉血氧分压(P(a,O2))(84毫米汞柱)无显著变化。

  3. 测试了含2% - 10%二氧化碳的21%氧气吸入气、含15%、10%或7.5%氧气且有无二氧化碳或有足够二氧化碳以维持正常碳酸血症的吸入气,以及含4%、6%或8%二氧化碳的15%或10%氧气吸入气。暴露2分钟后测量稳态反应。

  4. 通过三吸入气测试((i)单独缺氧,(ii)高碳酸血症,(iii)缺氧和高碳酸血症水平联合)确定的缺氧 - 高碳酸血症对V(E)、V(T)和f的相互作用,根据所检查的窒息程度得出了不同结论。本质上,窒息程度越轻,相互作用越呈相加甚至相乘,窒息程度越强,相互作用越呈阻塞性。然而,该测试不适合准确显示相互作用,因为窒息时达到的动脉血氧分压高于单纯缺氧时,且窒息时的动脉血二氧化碳分压低于单纯高碳酸血症时。

  5. 对于等氧条件(动脉血氧分压 = 97、77和51毫米汞柱),V(E)和V(T)与动脉血二氧化碳分压呈线性关系,而f与动脉血二氧化碳分压呈向上凸(动脉血氧分压97毫米汞柱)或向下凸(动脉血氧分压77和51毫米汞柱)的双曲线关系。

  6. 对于等碳酸条件(动脉血二氧化碳分压 = 33、40和48毫米汞柱),V(E)和V(T)与动脉血氧分压呈向下凸的双曲线反相关,而f与动脉血二氧化碳分压呈反线性关系(动脉血二氧化碳分压33毫米汞柱)或恒定(动脉血二氧化碳分压40和48毫米汞柱)。

  7. 多变量分析表明,缺氧 - 高碳酸血症相互作用对V(T)是相加性的,但对V(E)和f是阻塞性的,且后者的阻塞更严重。这通过将变量与动脉血二氧化碳分压或动脉血氧分压作图直观展示,即V(T)的回归线呈平行移动,窒息时V(E)的回归线更平缓,窒息时f几乎恒定。

  8. 将大鼠中V(E)对缺氧和高碳酸血症的反应及敏感性、V(E)、V(T)和f相对于动脉血氧分压和动脉血二氧化碳分压的回归线形状以及各变量上缺氧 - 高碳酸血症相互作用的类型与其他物种进行了比较。

  9. 考虑了大鼠中阻塞性缺氧 - 高碳酸血症相互作用的可能原因。

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