人体在低氧和高碳酸血症期间体位对压力和气流产生的影响。

Influence of body position on pressure and airflow generation during hypoxia and hypercapnia in man.

作者信息

Xie A, Takasaki Y, Popkin J, Orr D, Bradley T D

机构信息

Sleep Research Laboratory, Queen Elizabeth Hospital, Toronto, Ontario, Canada.

出版信息

J Physiol. 1993 Jun;465:477-87. doi: 10.1113/jphysiol.1993.sp019688.

DOI:10.1113/jphysiol.1993.sp019688

PMID:8229846

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1175441/

Abstract

Inspiratory oesophageal pressure and ventilatory responses to hyperoxic, progressive hypercapnic rebreathing (HCVR) and isocapnic, progressive hypoxic rebreathing (HVR) were studied in five normal males in both supine and upright seated positions. 2. No significant differences were found in the ventilatory response to hypercapnia between the supine and upright position. The slopes of the relationship between minute ventilation (VI) and the increase of end tidal PCO2 (delta P(ET), CO2) were 3.27 +/- 0.23 and 2.76 +/- 0.24 1 min-1 mmHg-1 supine and upright, respectively. However, the change in oesophageal pressure from the end expiratory level observed during quiet breathing to that at peak inspiration (delta P(oes), I) in relationship to delta P(ET),CO2 was greater supine than upright (1.23 +/- 0.07 versus 0.79 +/- 0.11 cmH2O mmHg-1, P < 0.01). 3. In contrast, during hypoxia-stimulated breathing the slope of the minute ventilation versus oxyhaemoglobin saturation curve (VI-Sa,O2) was flatter supine than upright (1.00 +/- 0.03 versus 1.75 +/- 0.05 l min-1 (percentage fall in Sa,O2)-1, P < 0.0001), but delta P(oes), I in relation to Sa,O2 during hypoxic rebreathing was similar supine and upright (0.38 +/- 0.03 versus 0.40 +/- 0.04 cmH2O (percentage fall in Sa,O2)-1, respectively. 4. It is concluded that body position does not affect the ventilatory response to progressive hyperoxic hypercapnia but does affect the relationship between delta P(oes), I and delta P(ET),CO2. In contrast, body position affects the ventilatory response to isocapnic progressive hypoxia, but does not affect the relationship between delta P(oes), I and Sa,O2.

摘要

对5名正常男性在仰卧位和直立坐位时的吸气食管压力以及对高氧、渐进性高碳酸血症再呼吸（HCVR）和等碳酸血症、渐进性低氧血症再呼吸（HVR）的通气反应进行了研究。2. 在仰卧位和直立位时，对高碳酸血症的通气反应未发现显著差异。仰卧位和直立位时，分钟通气量（VI）与呼气末PCO2升高（ΔP（ET），CO2）之间关系的斜率分别为3.27±0.23和2.76±0.24 l min-1 mmHg-1。然而，与ΔP（ET），CO2相关的，从安静呼吸时呼气末水平到吸气峰值时观察到的食管压力变化（ΔP（oes），I），仰卧位大于直立位（1.23±0.07对0.79±0.11 cmH2O mmHg-1，P<0.01）。3. 相反，在低氧刺激呼吸期间，仰卧位时分钟通气量与氧合血红蛋白饱和度曲线（VI-Sa，O2）的斜率比直立位时更平缓（1.00±0.03对1.75±0.05 l min-1（Sa，O2下降百分比）-1，P<0.0001），但低氧再呼吸期间与Sa，O2相关的ΔP（oes），I在仰卧位和直立位时相似（分别为0.38±0.03对0.40±0.04 cmH2O（Sa，O2下降百分比）-1）。4. 得出的结论是，体位不影响对渐进性高氧高碳酸血症的通气反应，但确实影响ΔP（oes），I与ΔP（ET），CO2之间的关系。相反，体位影响对等碳酸血症渐进性低氧血症的通气反应，但不影响ΔP（oes），I与Sa，O2之间的关系。