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人工通气犬的肺内气体混合与无效腔

Intrapulmonary gas mixing and dead space in artificially ventilated dogs.

作者信息

Schrikker A C, Wesenhagen H, Luijendijk S C

机构信息

Department of Medical Physiology and Sports Medicine, University of Utrecht, P.O. Box 80043, 3508 TA, Utrecht, The Netherlands.

出版信息

Pflugers Arch. 1995 Sep;430(5):862-70. doi: 10.1007/BF00386187.

Abstract

In this study we have investigated the effects of breath holding and of the physical properties of gases on four different respiratory dead spaces (VD): the Fowler, the physiological, the washout and the inert gas dead space. The experiments were performed with dogs which were ventilated artificially with breathing patterns with different post-inspiratory breath holding times (ta) of 0, 0.5, 1.0 and 2.0 s. Tracer amounts of acetone, ether and enflurane were infused continuously into a peripheral vein and a bolus of a mixture of krypton, Freon12 and SF6 was introduced into the peritoneal cavity. After reaching steady state, samples of arterial blood, mixed venous blood and mixed expired air were taken simultaneously. From the partial pressures (Pa, PV and PE respectively) we determined the excretion (E = PE/PV), retention (R = Pa/PV) and the physiological dead space fraction (VD,phys/VT = (1- PE/Pa)) for each gas, where VT is tidal volume. Further, we recorded the expirograms of the six tracer gases and of CO2 from which the Fowler dead space fractions (VD,Fowler/VT) of the different gases were determined. Also the washout dead space fractions (VD,washout/VT) for He and SF6 were determined as well as the inert gas dead space fraction (VD,MIGET/VT) with the use of the multiple inert gas elimination technique (MIGET). With the exception of VD,phys/VT for SF6, all dead space fractions decreased with increasing ta. VD,phys/VT for the poorly soluble gas SF6 was considerably larger than VD,phys/VT for the remaining gases. For the highly soluble acetone VFowler/VT was considerably smaller than VD,Fowler/VT for the other gases. VD,washout,SF6/VT was always larger than VD,washout,He/VT and VD,Fowler,SF6/VT. Further, VD,phys/VT was larger than VD,Fowler/VT for SF6 and acetone. However, for gases with intermediate solubility in blood VD,phys/VT tended to be smaller than VD,Fowler/VT. We conclude that the respiratory dead spaces are affected by the breathing pattern and by the physical properties of gases, i.e. their diffusivity in alveolar gas and their solubility in blood or lung tissue.

摘要

在本研究中,我们调查了屏气以及气体物理性质对四种不同呼吸死腔(VD)的影响:佛勒(Fowler)死腔、生理死腔、冲洗死腔和惰性气体死腔。实验用狗进行,通过不同吸气后屏气时间(ta)分别为0、0.5、1.0和2.0秒的呼吸模式进行人工通气。将微量的丙酮、乙醚和安氟醚持续注入外周静脉,并将氪、氟利昂12和六氟化硫的混合物团注引入腹腔。达到稳态后,同时采集动脉血、混合静脉血和混合呼出气体样本。根据分压(分别为Pa、PV和PE),我们确定了每种气体的排出率(E = PE/PV)、潴留率(R = Pa/PV)和生理死腔分数(VD,phys/VT = (1 - PE/Pa)),其中VT是潮气量。此外,我们记录了六种示踪气体和二氧化碳的呼气图,据此确定了不同气体的佛勒死腔分数(VD,Fowler/VT)。还确定了氦气和六氟化硫的冲洗死腔分数(VD,washout/VT)以及使用多惰性气体消除技术(MIGET)确定的惰性气体死腔分数(VD,MIGET/VT)。除六氟化硫的VD,phys/VT外,所有死腔分数均随ta增加而降低。难溶性气体六氟化硫的VD,phys/VT明显大于其余气体的VD,phys/VT。对于高溶性的丙酮,VFowler/VT明显小于其他气体的VD,Fowler/VT。VD,washout,SF6/VT总是大于VD,washout,He/VT和VD,Fowler,SF6/VT。此外,六氟化硫和丙酮的VD,phys/VT大于VD,Fowler/VT。然而,对于血液中溶解度中等的气体,VD,phys/VT往往小于VD,Fowler/VT。我们得出结论,呼吸死腔受呼吸模式和气体物理性质的影响,即它们在肺泡气中的扩散率以及在血液或肺组织中的溶解度。

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