Salerno F G, Moretto A, Dallaire M, Ludwig M S
Meakins-Christie Laboratories, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
J Appl Physiol (1985). 1995 Jan;78(1):282-7. doi: 10.1152/jappl.1995.78.1.282.
Challenges with high concentrations of constrictor agonist delivered by intravenous vs. aerosol result in different modifications of the mechanical properties of lung tissues. We questioned whether low doses of a smooth muscle agonist administered via different routes (aerosol, i.v. bolus, i.v. continuous infusion) or an increase in positive end-expiratory pressure (PEEP) would result in different mechanical perturbations of lung tissues. Tracheal and alveolar pressures and flow were measured in open-chest mechanically ventilated (frequency 1 Hz, tidal volume 10 ml/kg, PEEP 4 cmH2O) rats under baseline conditions and after administration of low doses of methacholine or after increases in PEEP. We calculated lung elastance (EL), lung resistance, and tissue resistance (Rti) by fitting the equation of motion to changes in tracheal and alveolar pressures. Airway resistance and hysteresivity (eta) were derived from the above measurements. For comparable increases in Rti, the aerosol and PEEP groups showed large increases in EL with a decrease in eta, whereas the two intravenous groups showed large increases in eta with smaller increases in EL. The largest contribution of eta to the overall increase in Rti was seen in the intravenous bolus group. When induced changes in EL vs. induced changes in eta were plotted, different relationships were found for the four groups. We conclude that despite similar increases in Rti a different kind of mechanical perturbation occurred in the lung tissues that depended on the nature of the stimulus.
静脉注射与雾化吸入高浓度收缩剂激动剂所面临的挑战会导致肺组织机械特性的不同改变。我们质疑通过不同途径(雾化、静脉推注、静脉持续输注)给予低剂量平滑肌激动剂或增加呼气末正压(PEEP)是否会导致肺组织不同的机械扰动。在基础条件下以及给予低剂量乙酰甲胆碱后或增加PEEP后,对开胸机械通气(频率1Hz,潮气量10ml/kg,PEEP 4cmH₂O)的大鼠测量气管和肺泡压力及流量。我们通过将运动方程拟合到气管和肺泡压力变化来计算肺弹性(EL)、肺阻力和组织阻力(Rti)。气道阻力和滞后性(eta)由上述测量得出。对于Rti的可比增加,雾化和PEEP组的EL大幅增加,eta降低,而两个静脉注射组的eta大幅增加,EL增加较小。eta对Rti总体增加的最大贡献出现在静脉推注组。当绘制EL的诱导变化与eta的诱导变化时,四组呈现出不同的关系。我们得出结论,尽管Rti有相似的增加,但肺组织中发生了不同类型的机械扰动,这取决于刺激的性质。