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犬肺血管对低氧的反应变异性及其与气体交换的关系

Variability of the pulmonary vascular response to hypoxia and relation to gas exchange in dogs.

作者信息

Forrest J B, Fargas-Babjak A

出版信息

Can Anaesth Soc J. 1978 Nov;25(6):479-87. doi: 10.1007/BF03007410.

Abstract

Anaesthetized and mechanically ventilated dogs were subjected to five minutes of alveolar hypoxia with Fio2 ranging from 0.08 to 0.20 while pulmonary artery pressure (Ppa), pulmonary wedge pressure (Pwp) and cardiac output (Q) were measured. Hypoxia increased Ppa in all dogs whereas Pwp and Q did not change significantly. Thus pulmonary vascular resistance (PVR) increased by a mean for all dogs of 56 per cent. There was great variation in the absolute increase in Ppa and PVR between animals and these were not statistically correlated with arterial Po2, but highly significant and reproduceable inverse relationships were found for Ppa and PVR against arterial oxygen per cent saturation. The slopes of these responses varied between dogs from -0.013 to -0.144 for PVR and from -0.038 to -0.561 for Ppa. The alveolar-arterial oxygen gradient and the pulmonary shunt fraction were reduced in a similar way with decreasing arterial oxygen per cent saturation, but dead space/tidal volume ratio remained unchanged. Thus the slope of PVR response to hypoxia against arterial oxygen per cent saturation is unique for individual animals. This may reflect functional and likely structural adaptations of the pulmonary vascular smooth muscle.

摘要

对麻醉并进行机械通气的犬只,在吸入氧分数(Fio2)为0.08至0.20的情况下使其经历五分钟的肺泡低氧,同时测量肺动脉压(Ppa)、肺楔压(Pwp)和心输出量(Q)。低氧使所有犬只的Ppa升高,而Pwp和Q无显著变化。因此,所有犬只的肺血管阻力(PVR)平均增加了56%。不同动物之间Ppa和PVR的绝对增加存在很大差异,且这些与动脉血氧分压无统计学相关性,但发现Ppa和PVR与动脉血氧饱和度百分比之间存在高度显著且可重复的反比关系。这些反应的斜率在不同犬只之间有所不同,PVR为-0.013至-0.144,Ppa为-0.038至-0.561。随着动脉血氧饱和度百分比降低,肺泡-动脉氧梯度和肺分流分数以类似方式降低,但死腔/潮气量比值保持不变。因此,PVR对低氧的反应斜率相对于动脉血氧饱和度百分比对个体动物而言是独特的。这可能反映了肺血管平滑肌的功能及可能的结构适应性。

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