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姿势对稳态低氧和高碳酸血症通气反应的影响。

Effect of posture on ventilatory response to steady-state hypoxia and hypercapnia.

作者信息

Mannix S E, Bye P, Hughes J M, Cover D, Davies E E

出版信息

Respir Physiol. 1984 Oct;58(1):87-99. doi: 10.1016/0034-5687(84)90047-1.

Abstract

The ventilatory response to steady-state normocapnic hypoxia and hypercapnia was measured in eight normal subjects after 15 min inhalation of 10.5% oxygen (with added CO2) or 4.2% CO2 in air through a loose-fitting high-flow Venturi mask. The erect (sitting) and the supine postures were studied. Ventilation was measured with inductance coils around the chest and the abdomen (Respitrace). Oxygen saturation was measured with an ear oximeter and PCO2 was measured transcutaneously on forearm skin using a modified pH electrode (Radiometer). In the erect posture (without stimulation), compared to supine, VE(21%) and VT/TI(32%) were greater but TI(19%) and TE(8%), abdominal contribution to tidal volume (24%) and 'arterial' PCO2 (0.6 mm Hg) were less. The mean ventilatory response to hypoxia at an 'arterial' PCO2 of 41 +/- 4 mm Hg (SD) was 0.61 +/- 0.34 L X min-1 X Sa-1O2 erect and 0.84 +/- 0.58 supine and to hypercapnia 2.89 +/- 1.4 L X min-1 X mm Hg-1 erect and 3.73 +/- 2.35 supine. The postural differences did not reach statistical significance. The pattern of response to both stimuli was similar, with doubling of VT, constant TI and slight shortening of TE. The abdominal contribution to tidal volume decreased by 9% with both forms of stimulation. In the steady state, the response to peripheral and central chemoreceptor stimuli was identical and essentially independent of position.

摘要

通过宽松的高流量文丘里面罩,让8名正常受试者吸入含10.5%氧气(添加二氧化碳)或4.2%二氧化碳的空气15分钟后,测量其对稳态等碳酸血症性低氧和高碳酸血症的通气反应。研究了直立(坐姿)和仰卧姿势。使用围绕胸部和腹部的电感线圈(Respitrace)测量通气量。用耳血氧仪测量血氧饱和度,使用改良的pH电极(Radiometer)经皮测量前臂皮肤的PCO2。在直立姿势(无刺激)下,与仰卧相比,分钟通气量(增加21%)和潮气量/吸气时间(增加32%)更大,但吸气时间(减少19%)、呼气时间(减少8%)、腹部对潮气量的贡献(减少24%)和“动脉”PCO2(降低0.6 mmHg)更小。在“动脉”PCO2为41±4 mmHg(标准差)时,对低氧的平均通气反应在直立时为0.61±0.34 L·min-1·SaO2-1,仰卧时为0.84±0.58;对高碳酸血症的通气反应在直立时为2.89±1.4 L·min-1·mmHg-1,仰卧时为3.73±2.35。姿势差异未达到统计学意义。对两种刺激的反应模式相似,潮气量翻倍,吸气时间不变,呼气时间略有缩短。两种刺激形式下,腹部对潮气量的贡献均减少9%。在稳态下,对周围和中枢化学感受器刺激的反应相同,且基本与体位无关。

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