Tsuji C, Kondo T, Kurata T, Kuwahira I, Ohta Y
Tokai J Exp Clin Med. 1982 Sep;7(5):575-82.
Anesthetized, mechanically ventilated dogs were used to study the effects of inspiratory pressure oscillation on gas exchange. Respiratory failure was induced in dogs artificially, changing either tidal volume or ventilatory rate. Pressure oscillation of approximately 2 Hz with amplitudes of 2 to 7 cmH2O was applied on the inspiratory phase of mechanical ventilation. PaO2 and PaCO2 were improved consistently by pressure oscillation while minute ventilation was kept fixed. No significant change was observed in AaDO2, cardiac output, heart rate, ECG and both systemic and pulmonary arterial pressures under oscillated ventilation. The oscillated ventilation could be continued for more than 60 minutes without causing any significant change in circulatory function. The ratio of alveolar ventilation to minute ventilation (VA/VE) increased and that of dead space to tidal volume (VD/VT) decreased significantly. The oscillated ventilation while breathing He-O2 and SF6-O2 showed no consistent difference in the effects on gas exchange. It can be concluded that simple pressure oscillation improves gas mixing in the lungs and may be applied to respiratory care. However the mechanism remains to be elucidated.
使用麻醉、机械通气的犬来研究吸气压力振荡对气体交换的影响。通过人为改变潮气量或通气频率诱导犬发生呼吸衰竭。在机械通气的吸气阶段施加频率约为2Hz、幅度为2至7cmH₂O的压力振荡。在分钟通气量保持固定的情况下，压力振荡可使动脉血氧分压（PaO₂）和动脉血二氧化碳分压（PaCO₂）持续改善。在振荡通气下，肺泡-动脉血氧分压差（AaDO₂）、心输出量、心率、心电图以及体循环和肺动脉压力均未观察到显著变化。振荡通气可持续60多分钟而不引起循环功能的任何显著变化。肺泡通气与分钟通气量之比（VA/VE）增加，死腔与潮气量之比（VD/VT）显著降低。在呼吸氦氧混合气和六氟化硫氧混合气时进行振荡通气，对气体交换的影响未显示出一致差异。可以得出结论，单纯的压力振荡可改善肺内气体混合，可应用于呼吸治疗。然而，其机制仍有待阐明。
