高碳酸血症和高碳酸血症性低氧血症中有无缓冲情况下低温的影响。
Effects of hypothermia with and without buffering in hypercapnia and hypercapnic hypoxemia.
作者信息
Wetterberg T, Sjöberg T, Steen S
机构信息
Department of Anaesthesiology, University of Lund, Sweden.
出版信息
Acta Anaesthesiol Scand. 1994 Apr;38(3):293-9. doi: 10.1111/j.1399-6576.1994.tb03892.x.
Anesthetized, paralyzed and mechanically ventilated pigs were hypoventilated to extreme hypercapnia (PaCO2 approximately 20 kPa) at FiO2 0.5, and allotted to receive hypothermia (approximately 31.5 degrees C) and buffer infusion, (HB-group, n = 6) or to a hypothermic control group (H-group, n = 6). The HB-group had higher arterial pH (7.34 vs 7.09, P < 0.01) and plasma bicarbonate (58.8 vs 35.4 mmol.l-1, P < 0.01) than the controls, but lower mean pulmonary arterial pressure (MPAP), (16 vs 23 mmHg (2.1 vs 3.1 kPa), P < 0.01) and pulmonary vascular resistance (PVR), (512 vs 699 dyn.s.cm-5 (5120 vs 6990 microN.s.cm-5), P < 0.05). Mixed venous PO2 (PVO2) was lower in the HB-group (5.1 vs 6.8 kPa, P < 0.01), as well as serum potassium (2.8 vs 3.7 mmol.l-1, P < 0.01) and ionized calcium (1.01 vs 1.29 mmol.l-1, P < 0.01). Subsequently, the inspired oxygen fraction (FiO2) was decreased stepwise (0.3, 0.25, 0.21, 0.15, 0.10) at 30 min intervals. At FiO2 0.3, the HB-group had lower PVO2 (6.6 vs 7.8 kPa, P < 0.01), O2 half saturation tension (3.6 vs 4.2 kPa, P < 0.01), MPAP (17 vs 25 mmHg (2.3 vs 3.3 kPa, P < 0.01) and PVR (598 vs 793 dyn.s.cm-5 (5980 vs 7930 microN.s.cm-5, P < 0.05) compared with the controls, but higher arterial O2 saturation (95.3 vs. 88.6%, P < 0.01) and O2 content (17.7 vs 15.7 ml.100 ml-1, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
将麻醉、麻痹并进行机械通气的猪在吸入氧分数（FiO2）为0.5的情况下进行低通气，使其达到极度高碳酸血症（动脉血二氧化碳分压[PaCO2]约为20 kPa），然后将其分为接受低温（约31.5摄氏度）和缓冲液输注的组（HB组，n = 6）或低温对照组（H组，n = 6）。与对照组相比，HB组的动脉血pH值更高（7.34对7.09，P < 0.01），血浆碳酸氢盐更高（58.8对35.4 mmol·l-1，P < 0.01），但平均肺动脉压（MPAP）更低（16对23 mmHg[2.1对3.1 kPa]，P < 0.01），肺血管阻力（PVR）更低（512对699 dyn·s·cm-5[5120对6990 μN·s·cm-5]，P < 0.05）。HB组的混合静脉血氧分压（PVO2）更低（5.1对6.8 kPa，P < 0.01），血清钾更低（2.8对3.7 mmol·l-1，P < 0.01），离子钙更低（1.01对1.29 mmol·l-1，P < 0.01）。随后，每隔30分钟逐步降低吸入氧分数（FiO2）（0.3、0.25、0.21、0.15、0.10）。在FiO2为0.3时，与对照组相比，HB组的PVO2更低（6.6对7.8 kPa，P < 0.01），氧半饱和张力更低（3.6对4.2 kPa，P < 0.01），MPAP更低（17对25 mmHg[2.3对3.3 kPa，P < 0.01]），PVR更低（598对793 dyn·s·cm-5[5980对7930 μN·s·cm-5，P < 0.05]），但动脉血氧饱和度更高（95.3对88.6%，P < 0.01），氧含量更高（17.7对15.7 ml·100 ml-1，P < 0.05）。（摘要截选至250词）
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