Tütüncü A S, Faithfull N S, Lachmann B
Department of Anesthesiology, Erasmus University Rotterdam, The Netherlands.
Am Rev Respir Dis. 1993 Sep;148(3):785-92. doi: 10.1164/ajrccm/148.3.785.
We investigated the efficacy of intratracheal perfluorocarbon (PFC) administration combined with mechanical ventilation to support gas exchange in adult animals with acute respiratory failure. These were compared with a similar group of animals treated with continuous positive-pressure ventilation (CPPV) with respect to respiratory parameters and postmortem lung histology. After lung lavage with saline, 18 adult rabbits were divided into three groups (n = 6 per group). All groups received conventional CPPV. Additionally, one group received intratracheal PFC administration at a volume of 18 ml/kg (corresponding to functional residual capacity) (PFC group); another received 18 ml/kg of saline administration (saline group), and the last had no further treatment (CPPV group). All groups were ventilated for 3 h using 100% oxygen, with the same ventilator settings of tidal volume of 12 ml/kg, respiratory frequency of 30/min, and positive end-expiratory pressure of 6 cm H2O. In the PFC group, PaO2 increased from 67.2 +/- 11.4 to 424.2 +/- 14 mm Hg and remained stable for 3 h with well-preserved PaCO2 values. Only in the PFC group were significant decreases in airway pressures and increase in respiratory system compliance seen. In the CPPV group, PaO2 stayed around 60 mm Hg and PaCO2 gradually increased. PFC treatment with conventional mechanical ventilation in acute respiratory failure proved to be a successful supportive technique to improve gas exchange at low inflation pressures.
我们研究了气管内注入全氟化碳(PFC)联合机械通气对支持急性呼吸衰竭成年动物气体交换的疗效。将这些动物与接受持续正压通气(CPPV)的相似动物组在呼吸参数和死后肺组织学方面进行比较。用生理盐水进行肺灌洗后,将18只成年兔分为三组(每组n = 6)。所有组均接受常规CPPV。此外,一组以18 ml/kg的体积(相当于功能残气量)接受气管内PFC注入(PFC组);另一组接受18 ml/kg的生理盐水注入(生理盐水组),最后一组不进行进一步治疗(CPPV组)。所有组均使用100%氧气通气3小时,呼吸机设置相同,潮气量为12 ml/kg,呼吸频率为30次/分钟,呼气末正压为6 cm H₂O。在PFC组中,动脉血氧分压(PaO₂)从67.2±11.4升至424.2±14 mmHg,并在3小时内保持稳定,动脉血二氧化碳分压(PaCO₂)值保持良好。仅在PFC组中观察到气道压力显著降低和呼吸系统顺应性增加。在CPPV组中,PaO₂维持在60 mmHg左右,PaCO₂逐渐升高。在急性呼吸衰竭中,PFC联合传统机械通气治疗被证明是一种在低充气压力下改善气体交换的成功支持技术。