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人体胸廓和膈肌-腹部通路在放松状态与麻痹状态下的顺应性。

Compliances of human rib cage and diaphragm-abdomen pathways in relaxed versus paralyzed states.

作者信息

Vellody V P, Nassery M, Balasaraswathi K, Goldberg N B, Sharp J T

出版信息

Am Rev Respir Dis. 1978 Sep;118(3):479-91. doi: 10.1164/arrd.1978.118.3.479.

Abstract

The respiratory magnetometer method of Konno and Mead was used to measure separately the rib cage and the diaphragm-abdomen components of the total respiratory system compliance in 11 subjects with normal respiratory systems. Measurements made in the awake, relaxed state by the method of Heaf and Prime were compared with similar measurements made in the anesthetized, paralyzed state by the supersyringe method. The rib cage component was greater in the paralyzed than the relaxed state in 9 of 11 subjects, but the diaphragm-abdomen component was greater in the relaxed than the paralyzed state in 8 of 11 subjects. We believe that these differences can be explained by respiratory muscle activity in the presumed relaxed state. The fraction of the tidal volume attributable to rib cage displacement compared to abdominal displacement was greater during mechanical ventilation in the paralyzed state than during awake, spontaneous breathing. This can be explained by the different distribution of inflating forces produced by diaphragmatic contraction compared to positive airway and alveolar pressure, in particular by the very different patterns of diaphragmatic displacement in the 2 states.

摘要

运用Konno和Mead的呼吸磁强计法,对11名呼吸系统正常的受试者的全呼吸系统顺应性的胸腔和膈肌 - 腹部成分进行了分别测量。将通过Heaf和Prime方法在清醒、放松状态下所做的测量,与通过超级注射器法在麻醉、麻痹状态下所做的类似测量进行了比较。在11名受试者中,有9名受试者胸腔成分在麻痹状态下比放松状态时更大,但有8名受试者膈肌 - 腹部成分在放松状态下比麻痹状态时更大。我们认为,这些差异可以通过假定放松状态下的呼吸肌活动来解释。与腹部移位相比,在麻痹状态下机械通气期间,潮气量中归因于胸腔移位的部分比清醒时自主呼吸期间更大。这可以通过膈肌收缩产生的充气力量与气道正压和肺泡压力的不同分布来解释,特别是通过这两种状态下膈肌移位的非常不同的模式来解释。

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