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单肺肺泡容积与气体交换:对侧肺膨胀的影响

Single lung alveolar volume and gas transfer: effect of expansion of the other lung.

作者信息

Johansen B, Bjørtuft O

机构信息

Department of Thoracic Medicine, Rikshospitalet, National Hospital, University of Oslo, Norway.

出版信息

Thorax. 1994 Dec;49(12):1238-42. doi: 10.1136/thx.49.12.1238.

Abstract

BACKGROUND

Temporary occlusion of one mainstem bronchus permits measurement of single lung function. A previous study suggested that the volume at which one lung is occluded may influence the expansion of the other. The effect of ipsilateral occlusion volume on the contralateral effective alveolar volume (VA, EFF,SL), inspired volume (VI,SL), single breath estimated residual volume (RVSB,SL), carbon monoxide (CO) transfer (TLCO,SL) and transfer coefficient (KCO,SL) has been examined.

METHODS

Single breath measurements of CO transfer were made in duplicate in 12 healthy subjects aged 19-44 years, without and during occlusion of one mainstem bronchus by a balloon at RV and at total lung capacity (TLC).

RESULTS

Mean VA,EFF,SL, VI,SL, and TLCO,SL were lower during occlusion at RV than during occlusion at TLC (2.84 v 3.26 l; 2.18 v 2.54 l; and 4.70 v 5.51 mmol/kPa/min respectively). RVSB,SL was independent of occlusion volume and KCO,SL not different from the KCO of both lungs (KCO,BL). Single lung values during occlusion at TLC were fairly reproducible and were, except for KCO,SL, approximately half the values for both lungs. During occlusion at RV the second TLCO,SL and KCO,SL were lower than the first.

CONCLUSIONS

Occlusion of one lung permits reliable determinations of gas transfer indices of the other, provided the lung is occluded at TLC. Occlusion at RV significantly reduces VA,EFF,SL, and hence TLCO,SL, but does not affect KCO,SL of the other lung.

摘要

背景

临时阻断一侧主支气管可用于测量单肺功能。先前的一项研究表明,阻断一侧肺的容积可能会影响另一侧肺的扩张。本研究探讨了同侧阻断容积对健侧有效肺泡容积(VA,EFF,SL)、吸入容积(VI,SL)、单次呼吸估计残气量(RVSB,SL)、一氧化碳(CO)转运(TLCO,SL)和转运系数(KCO,SL)的影响。

方法

对12名年龄在19 - 44岁的健康受试者,在右心室(RV)和肺总量(TLC)时,分别在未阻断和用球囊阻断一侧主支气管的情况下,重复进行单次呼吸CO转运测量。

结果

RV阻断时的平均VA,EFF,SL、VI,SL和TLCO,SL低于TLC阻断时(分别为2.84对3.26升;2.18对2.54升;4.70对5.51毫摩尔/千帕/分钟)。RVSB,SL与阻断容积无关,KCO,SL与双肺的KCO(KCO,BL)无差异。TLC阻断时的单肺值具有相当的可重复性,除KCO,SL外,约为双肺值的一半。RV阻断时,第二次测量的TLCO,SL和KCO,SL低于第一次。

结论

如果在TLC时阻断一侧肺,则可可靠地测定另一侧肺的气体转运指标。RV阻断会显著降低VA,EFF,SL,从而降低TLCO,SL,但不影响另一侧肺的KCO,SL。

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本文引用的文献

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Hysteresis in the relation between diffusing capacity of the lung and lung volume.肺弥散能力与肺容积之间关系中的滞后现象。
J Appl Physiol Respir Environ Exerc Physiol. 1980 Oct;49(4):566-70. doi: 10.1152/jappl.1980.49.4.566.

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