Aoyagi M
Anesthesia Service, Chiba National Hospital.
Masui. 1995 Mar 3;44(3):331-7.
Aspiration of acid gastric contents into the airways is a major cause of pulmonary injury. The author investigated the effects of intratracheal instillation of hydrochloric acid in the anesthetized dogs on pulmonary hemodynamics, pulmonary lymph flow and protein content, and stable metabolites of prostaglandin F2 alpha (PGF2 alpha), prostacyclin (PGI2) and thromboxane A2 (TXA2). The author measured the concentrations of 15-keto-13, 14-H2-PGF2 alpha, 6-keto-PGF1 alpha and TXB2 in blood and pulmonary (right duct) lymph by specific radioimmunoassay. After intratracheal instillation of 0.1 N HCL, 3 ml.kg-1, the right duct lymph flow increased significantly from 1.3 to 4.5 ml.h-1, and pulmonary lymph-to-plasma protein ratio increased significantly from 0.63 to 0.70. There was no significant change in hemodynamics after acid instillation. There was no significant change in arterial or mixed-venous blood levels of any of the three metabolites. After acid instillation, the right duct lymph concentrations increased 2-fold for PGI2 metabolite, 3-fold for TXB2, and 7-fold for PGF2 alpha metabolite. The flow of metabolites (concentration x flow) increased 13-fold for 6-keto-PGF1 alpha, 14-fold for TXB2, and 40-fold for PGF1 alpha metabolite. The author concludes that intratracheal instillation of hydrochloric acid in anesthetized dogs: 1) increases pulmonary microvascular permeability, and 2) stimulates the pulmonary generation of PGF2 alpha, prostacyclin and thromboxane, and that 3) the analysis of pulmonary lymph flow and its constituents is a useful means for the study of lung injuries.
酸性胃内容物吸入气道是肺部损伤的主要原因。作者研究了在麻醉犬气管内滴注盐酸对肺血流动力学、肺淋巴流量和蛋白质含量以及前列腺素F2α(PGF2α)、前列环素(PGI2)和血栓素A2(TXA2)的稳定代谢产物的影响。作者通过特异性放射免疫测定法测量了血液和肺(右导管)淋巴中15-酮-13,14-二氢-PGF2α、6-酮-PGF1α和TXB2的浓度。在气管内滴注0.1N HCL,3ml.kg-1后,右导管淋巴流量从1.3显著增加至4.5ml.h-1,肺淋巴与血浆蛋白比值从0.63显著增加至0.70。滴注酸后血流动力学无显著变化。三种代谢产物的动脉血或混合静脉血水平均无显著变化。滴注酸后,右导管淋巴中PGI2代谢产物浓度增加2倍,TXB2增加3倍,PGF2α代谢产物增加7倍。代谢产物流量(浓度×流量)6-酮-PGF1α增加13倍,TXB2增加14倍,PGF1α代谢产物增加40倍。作者得出结论,在麻醉犬气管内滴注盐酸:1)增加肺微血管通透性,2)刺激肺产生PGF2α、前列环素和血栓素,3)分析肺淋巴流量及其成分是研究肺损伤的有用方法。