John E, Ermocilla R, Golden J, McDevitt M, Cassady G
Br J Exp Pathol. 1980 Jun;61(3):315-23.
We ventilated 10 healthy young rabbits with warm moist air at 20 cm H2O peak airway pressure and compared their pulmonary histology to that of 10 controls. The histological changes were analysed using the Leitz Texture Analysis System. Four hundred high-power fields (240 micrometers X 240 micrometers) were scanned from each section and the mean proportions of air space, interstitium and oedema determined. Calculated bicarbonate decreased significantly in both groups (P < 0.05); this was accompanied by a modest decrease in pHa in the ventilated group. The PaO2 and PaCO2 were maintained within the normal range. The blood pressure decreased in both groups. Seven of 10 ventilated rabbits had interstitial widening while only 1 of 10 controls had a similar lesion (chi 2 = 5.21, P = < 0.05). The area occupied by interstitium ranged from 26 to 46% (mean 37.6%) in controls and 18 to 81% (mean 45.4%) in ventilated rabbits. There was a lack of correlation between clinical and histopathological findings. While 6 of 10 ventilated rabbits had intra-alveolar oedema and a decrease in air space to less than 50% of total area, none developed hypoxaemia. Two of these 6 rabbits also had pHa less than 7.35 by the end of the study, yet all were clinically stable. These data indicate that intermittent partial-pressure ventilation with warm moist air may result in pulmonary parenchymal damage within 6 h in healthy rabbits.
我们用峰值气道压力为20 cm H₂O的温暖潮湿空气对10只健康的幼兔进行通气,并将它们的肺部组织学与10只对照兔的进行比较。使用Leitz纹理分析系统分析组织学变化。从每个切片中扫描400个高倍视野(240微米×240微米),并确定气腔、间质和水肿的平均比例。两组的计算碳酸氢盐均显著降低(P < 0.05);通气组的动脉血pH值也有适度下降。动脉血氧分压(PaO₂)和动脉血二氧化碳分压(PaCO₂)维持在正常范围内。两组的血压均下降。10只通气兔中有7只出现间质增宽,而10只对照兔中只有1只出现类似病变(χ² = 5.21,P = < 0.05)。对照组间质所占面积为26%至46%(平均37.6%),通气兔为18%至81%(平均45.4%)。临床和组织病理学结果之间缺乏相关性。10只通气兔中有6只出现肺泡内水肿,气腔面积减少至总面积的50%以下,但均未发生低氧血症。在研究结束时,这6只兔中有2只的动脉血pH值也低于7.35,但所有兔临床均稳定。这些数据表明,在健康兔中,用温暖潮湿空气进行间歇性分压通气可能在6小时内导致肺实质损伤。