Clarke J R, Rogers J
Undersea Biomed Res. 1982 Mar;9(1):21-35.
The hypothesis that reduced lung compliance increases barotrauma susceptibility was tested in isolated hamster lungs. Elastase, instilled intratracheally in some hamsters from 4 h up to 8 days prior to testing, caused a patchy distribution of acute suppurative bronchiolitis and pneumonia. Airway blockage and decreased compliance were the anticipated results. For testing, anesthetized animals were ventilated with positive end-expiratory pressure prior to opening of the chest wall; this minimum pressure was maintained throughout testing. Transpulmonary pressure and lung volume changes, determined plethysmographically, were used to calculate quasi-static (C) and dynamic compliance (Cdyn) over a 2-ml tidal volume at frequencies up to 120 breaths/min. Some lungs were exposed, airway open, to a vacuum to stimulate a rapid ascent to the surface. All lungs were eventually pressurized through the trachea to determine rupture pressure (Pr). Rupture pressure exhibited an unexpected dichotomy apparently unrelated to elastase exposure. Statistically C did not differ between the elastase-treated and nontreated animals. Compliance correlated with Pr in a well-defined group (elastase-treated, nonevacuated lungs), but compliance had no value in predicting Pr for the group as a whole.
在离体仓鼠肺中对肺顺应性降低会增加气压伤易感性这一假说进行了测试。在测试前4小时至8天内,对部分仓鼠经气管内滴注弹性蛋白酶,导致急性化脓性细支气管炎和肺炎呈斑片状分布。气道阻塞和顺应性降低是预期结果。为进行测试,在打开胸壁前对麻醉动物采用呼气末正压通气;在整个测试过程中维持此最低压力。通过体积描记法测定跨肺压和肺容积变化,用于计算潮气量为2毫升、频率高达每分钟120次呼吸时的准静态顺应性(C)和动态顺应性(Cdyn)。部分肺暴露在外,气道开放,置于真空中以模拟快速上升至水面的情况。最终通过气管对所有肺进行加压以确定破裂压力(Pr)。破裂压力呈现出一种意想不到的二分法,显然与弹性蛋白酶暴露无关。经统计学分析,弹性蛋白酶处理组和未处理组动物的C无差异。在一个明确的组(经弹性蛋白酶处理、未置于真空中的肺)中,顺应性与Pr相关,但总体而言顺应性对预测Pr并无价值。