Slutsky A S, Kamm R D, Rossing T H, Loring S H, Lehr J, Shapiro A H, Ingram R H, Drazen J M
J Clin Invest. 1981 Dec;68(6):1475-84. doi: 10.1172/jci110400.
Recent studies have shown that effective pulmonary ventilation is possible with tidal volumes (VT) less than the anatomic dead-space if the oscillatory frequency (f) is sufficiently large. We systematically studied the effect on pulmonary CO2 elimination (VCO2) of varying f (2-30 Hz) and VT (1-7 ml/kg) as well as lung volume (VL) in 13 anesthetized, paralyzed dogs in order to examine the contribution of those variables that are thought to be important in determining gas exchange by high frequency ventilation. All experiments were performed when the alveolar PCO2 was 40 +/- 1.5 mm Hg. In all studies, VCO2 increased monotonically with f at constant VT. We quantitated the effects of f and VT on VCO2 by using the dimensionless equation VCO2/VOSC = a(VT/VTo)b(f/fo)c where: VOSC = f X VT, VTo = mean VT, fo = mean f and a, b, c, are constants obtained by multiple regression. The mean values of a, b, and c for all dogs were 2.12 X 10(-3), 0.49, and 0.08, respectively. The most important variable in determining VCO2 was VOSC; however, there was considerable variability among dogs in the independent effect of VT and f on VCO2, with a doubling of VT at a constant VOSC causing changes in VCO2 ranging from -13 to +110% (mean = +35%). Increasing VL from functional residual capacity (FRC) to the lung volume at an airway opening minus body surface pressure of 25 cm H2O had no significant effect on VCO2.
最近的研究表明,如果振荡频率(f)足够高,潮气量(VT)小于解剖无效腔时也能实现有效的肺通气。我们系统地研究了在13只麻醉、麻痹的犬中,改变频率(2 - 30Hz)、潮气量(1 - 7ml/kg)以及肺容积(VL)对肺二氧化碳排出量(VCO2)的影响,以检验那些被认为在高频通气决定气体交换中起重要作用的变量的贡献。所有实验均在肺泡PCO2为40±1.5mmHg时进行。在所有研究中,在恒定VT时,VCO2随f单调增加。我们使用无量纲方程VCO2/VOSC = a(VT/VTo)b(f/fo)c来量化f和VT对VCO2的影响,其中:VOSC = f×VT,VTo =平均VT,fo =平均f,a、b、c是通过多元回归得到的常数。所有犬的a、b、c平均值分别为2.12×10(-3)、0.49和0.08。决定VCO2的最重要变量是VOSC;然而,不同犬之间VT和f对VCO2的独立影响存在相当大的差异,在恒定VOSC时VT加倍导致VCO2的变化范围为 - 13%至 + 110%(平均 = + 35%)。将肺容积从功能残气量(FRC)增加到气道开口处减去体表压力为25cm H2O时的肺容积,对VCO2没有显著影响。