Gavriely N, Eckmann D M, Grotberg J B
Department of Anesthesia, Northwestern University Medical School, Chicago 60611, USA.
J Appl Physiol (1985). 1995 Jul;79(1):243-50. doi: 10.1152/jappl.1995.79.1.243.
High-frequency external chest vibration with tracheal insufflation (high-frequency vibration ventilation) has previously been shown to be an effective mode of artificial ventilation in experimental animals. To investigate the intra-airway gas mixing during high-frequency vibration ventilation (frequency 30 Hz, amplitude 0.4 cm), we used an analysis of the single-breath washout curve that gives the vibration-induced mixing coefficient distribution relative to the no-vibration situation. Data from four anesthetized dogs were collected during constant-flow insufflation at six rates (0.05-0.4 l.min-1.kg-1), at three insufflation durations (2, 4, and 7 s), and with the insufflation catheter outlet at three positions (carina, trachea, and a bronchus) while the vibration was on and off. Vibration enhanced intra-airway gas mixing 14.1 +/- 3.9-fold, with the peak of the enhancement distribution located 125 +/- 29 ml from the airway opening and a distribution width of 121 +/- 29 ml. As insufflation flow increased, the position of the peak enhancement shifted toward the alveolar zone and diminished in peak amplitude. Changing the insufflation duration and the catheter position did not affect the intra-airway mixing induced by vibration. External chest vibration causes a substantial increase of intra-airway gas mixing, bringing alveolar gas to central airways. This leads to overall increased pulmonary gas transport when fresh gas is insufflating the tracheal carina area.
先前已证明,采用气管内吹气的高频胸外振动(高频振动通气)在实验动物中是一种有效的人工通气模式。为了研究高频振动通气(频率30Hz,振幅0.4cm)期间气道内气体混合情况,我们对单次呼吸冲洗曲线进行了分析,该曲线给出了相对于无振动情况的振动诱导混合系数分布。在振动开启和关闭的情况下,以六种流速(0.05 - 0.4l·min⁻¹·kg⁻¹)、三种吹气持续时间(2、4和7秒)以及将吹气导管出口置于三个位置(隆突、气管和支气管),在四只麻醉犬进行恒流吹气期间收集数据。振动使气道内气体混合增强了14.1±3.9倍,增强分布的峰值位于距气道开口125±29ml处,分布宽度为121±29ml。随着吹气流量增加,增强峰值的位置向肺泡区移动且峰值幅度减小。改变吹气持续时间和导管位置并不影响振动诱导的气道内混合。胸外振动可使气道内气体混合大幅增加,将肺泡气体带至中央气道。当新鲜气体吹入气管隆突区域时,这会导致肺气体传输总体增加。