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[辅助通气中的呼吸调节]

[Regulation of respiration in assisted ventilation].

作者信息

Waurick S, König F

出版信息

Anaesthesist. 1984 Feb;33(2):89-95.

PMID:6424497
Abstract

Based on knowledge of the control of external respiration, the physiological reactions are discussed which should be evoked proprioceptively and chemoreceptively by an assisting respirator's disturbances of spontaneous breathing movements. The following possible states are discriminated: 1. "no adaption": the respiratory motor system does not remain passive during the machine's stroke; 2. "passive adaption": the respiratory motor system remains passive during the respirator's stroke; to changes of the blood gas-status, only the breathing frequency responds, but in just the same manner as during spontaneous ventilation; 3. "active adaption": the ventilatory motor apparatus remains passive during the respirator's operation; changes of the blood gases are responded to by the breathing frequency only, but in a manner different to spontaneous breathing and which compensates for the invariability of the fixed stroke-volume. - Related to these 3 states, consequences concerning the efficiency of chemical respiratory control can be derived which should reveal themselves during experimental manipulation of the blood gas partial pressures. Accordingly, the CO2-response curves of minute ventilation, breathing frequency and tidal-volume generated in 9 healthy, awake and cooperative subjects during spontaneous breathing and assisted (stroke-volume controlled) respiration with gas mixtures of 0, 3 and 6% CO2 were investigated and compared. (In each subject assisted ventilation with 2 or 3 different stroke-volumes was performed. The smallest stroke-volume equalled the medium tidal-volume of spontaneous ventilation. Every stroke-volume produced its particular CO2-response curve). Hence it follows that with assisted ventilation, using a stroke-volume larger than the spontaneous tidal-volume, the subjects maintain a state between "passive" and "active adaption".(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

基于对外呼吸控制的知识,本文讨论了辅助呼吸机干扰自主呼吸运动时,应通过本体感受和化学感受引发的生理反应。区分了以下几种可能的状态:1. “无适应”:在机器冲程期间,呼吸运动系统并非保持被动;2. “被动适应”:在呼吸机冲程期间,呼吸运动系统保持被动;对于血气状态的变化,只有呼吸频率做出反应,但其方式与自主通气时相同;3. “主动适应”:在呼吸机运行期间,通气运动装置保持被动;血气变化仅由呼吸频率做出反应,但其方式与自主呼吸不同,且能补偿固定潮气量的不变性。与这三种状态相关,可以得出关于化学呼吸控制效率的结论,这些结论应在对血气分压进行实验操作时显现出来。因此,研究并比较了9名健康、清醒且配合的受试者在自主呼吸以及使用0%、3%和6%二氧化碳混合气体进行辅助(潮气量控制)呼吸时,分钟通气量、呼吸频率和潮气量的二氧化碳反应曲线。(在每个受试者身上,进行了2种或3种不同潮气量的辅助通气。最小潮气量等于自主通气的平均潮气量。每种潮气量都产生了其特定的二氧化碳反应曲线。)因此可以得出结论,在辅助通气时,使用大于自主潮气量的潮气量,受试者会维持一种介于“被动”和“主动适应”之间的状态。(摘要截断于250字)

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