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犬肺切除术后心肺适应性。IV. 膜扩散容量和毛细血管血容量。

Cardiopulmonary adaptations to pneumonectomy in dogs. IV. Membrane diffusing capacity and capillary blood volume.

作者信息

Hsia C C, Herazo L F, Ramanathan M, Johnson R L

机构信息

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9034.

出版信息

J Appl Physiol (1985). 1994 Aug;77(2):998-1005. doi: 10.1152/jappl.1994.77.2.998.

Abstract

Lung diffusing capacity for carbon monoxide (DLco) and its components, membrane diffusing capacity (Dmco) and capillary blood volume (Vc), as well as pulmonary blood flow (Qc), were measured at rest at several lung volumes and during treadmill exercise by a rebreathing technique in four adult dogs after right pneumonectomy (R-PNX) and in six matched control dogs (Sham) 6-12 mo after surgery. In both groups, lung inflation at rest was associated with a small increase in DLco and Dmco but not in Vc. After R-PNX, total DLco was lower by 30% at peak exercise compared with control values. When compared with DLco in a normal left lung, DLco in the remaining lung continued to increase along the normal relationship with respect to Qc up to a cardiac output equivalent to 34 l/min through both lungs of the Sham dog. There was no evidence of an upper limit of DLco being reached. The augmentation of DLco from rest to exercise was associated with corresponding increases in Dmco and Vc; after R-PNX, both Dmco and Vc continued to increase with respect to Qc along similar relationships as in control dogs without reaching an upper limit, suggesting a much larger alveolar-capillary reserve for gas exchange by diffusion than previously recognized. At higher levels of blood flow through the remaining lung, DLco was greater in adult dogs after R-PNX than after left pneumonectomy (Carlin et al. J. Appl. Physiol. 70: 135-142, 1991), suggesting that additional sources of compensation, e.g., lung growth, exist after removal of > 50% of lung.

摘要

采用重呼吸技术,在术后6 - 12个月,对4只成年犬右肺切除(R - PNX)后及6只匹配的对照犬(假手术组)在静息状态下的几个肺容积时以及在跑步机运动期间测量一氧化碳肺弥散量(DLco)及其组成部分,膜弥散量(Dmco)和毛细血管血容量(Vc),以及肺血流量(Qc)。在两组中,静息时肺充气与DLco和Dmco的小幅增加有关,但与Vc无关。右肺切除后,与对照值相比,运动峰值时总DLco降低了30%。与正常左肺的DLco相比,剩余肺的DLco在相当于假手术组双肺心输出量达34 l/min之前,继续沿着与Qc的正常关系增加。没有证据表明达到了DLco的上限。DLco从静息到运动的增加与Dmco和Vc的相应增加有关;右肺切除后,Dmco和Vc相对于Qc继续沿着与对照犬相似的关系增加,且未达到上限,这表明通过扩散进行气体交换的肺泡 - 毛细血管储备比之前认识到的要大得多。在流经剩余肺的血流水平较高时,右肺切除后的成年犬的DLco比左肺切除后更大(Carlin等人,《应用生理学杂志》70: 135 - 142, 1991),这表明在切除超过50%的肺后存在额外的代偿来源,例如肺生长。

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