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肺静脉充血后气道口径的变化。

Changes in airway calibre following pulmonary venous congestion.

作者信息

Jones J G, Lemen R, Graf P D

出版信息

Br J Anaesth. 1978 Aug;50(8):743-52. doi: 10.1093/bja/50.8.743.

Abstract

"Closing volume" (CV) was measured in 18 anaesthetized dogs before, during and after pulmonary vascular congestion produced by inflation of a balloon placed in the left atrium. In group A 10 dogs were anaesthetized with pentobarbitone. CV increased from 30.0 +/- 1.2 to 42 +/- 5.6% of vital capacity (P less than 0.05) when pulmonary wedge pressure was increased from 0.21 +/- 0.27 to 1.54 +/- 0.44 kPa (1.6 +/- 2.0 to 11.6 +/- 3.3 mm Hg) (P less than 0.05). In seven of these 10 dogs gas exchange was impaired after an increase of left atrial pressure. These changes in lung function during pulmonary vascular congestion were not associated with an increase in lung water. In group B, eight dogs were studied after anaesthesia with chloralose and urethane. Vagotomy or vagal cooling to 0 degrees C returned CV to baseline values in six dogs with pulmonary vascular congestion. In two dogs in which bilateral vagotomy had been performed before pulmonary vascular congestion there was no change in CV after balloon inflation. Isoprenaline abolished the effect of pulmonary vascular congestion on closing volume. This suggests that the vagus mediates the changes in lung mechanics associated with pulmonary vascular congestion.

摘要

在18只麻醉犬身上测量了“闭合气量”(CV),测量时间分别为在置于左心房的球囊充气导致肺血管充血之前、期间和之后。A组中,10只犬用戊巴比妥麻醉。当肺楔压从0.21±0.27千帕(1.6±2.0毫米汞柱)升高至1.54±0.44千帕(11.6±3.3毫米汞柱)时(P<0.05),CV从肺活量的30.0±1.2%增加至42±5.6%(P<0.05)。在这10只犬中的7只,左心房压力升高后气体交换受损。肺血管充血期间肺功能的这些变化与肺水增加无关。B组中,8只犬在使用氯醛糖和氨基甲酸乙酯麻醉后接受研究。迷走神经切断术或将迷走神经冷却至0摄氏度可使6只肺血管充血犬的CV恢复至基线值。在2只在肺血管充血前已进行双侧迷走神经切断术的犬中,球囊充气后CV无变化。异丙肾上腺素消除了肺血管充血对闭合气量的影响。这表明迷走神经介导了与肺血管充血相关的肺力学变化。

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