Takeuchi H, Mitsuhata H, Saitoh J, Hasome N, Horiguchi Y, Shimizu R
Department of Anesthesiology, Jichi Medical School, Tochigi.
Masui. 1995 Nov;44(11):1513-9.
To evaluate efficacy of artificial ventilation with 100 % oxygen for treatment of IgE-mediated anaphylaxis, we compared survival of control ventilated dogs with one of dogs with spontaneous ventilation. Fourteen dogs sensitized to Toxica canis were randomly assigned to two groups: spontaneous respiration group (Group S, n = 8) and artificial ventilation group (Group A, n = 6). All dogs were anesthetized with pentobarbital. In Group S, all dogs breathed spontaneously with constant flow of 4 l.min-1 of oxygen. Spontaneous respiration maintained an end-tidal CO2 level between 40 and 50 mmHg. In Group A, the dogs, paralyzed with pancuronium, were ventilated mechanically with 100 % oxygen, and the tidal volume was adjusted to maintain an end-tidal CO2 level between 35 and 40 mmHg. After measurements of pulmonary resistance (RL), dynamic compliance (Cdyn), and circulatory parameters at baseline, Ascaris suum antigen was administered intravenously into the systemic circulation to induce IgE-mediated anaphylaxis. RL, Cdyn and circulatory parameters were recorded continuously for 120 min after antigen challenge. Analysis of arterial blood gases was done throughout the study. Survival rates were 100 % and 50 % in Group A and Group S, respectively. In 7 of 8 dogs in Group S, apnea was observed during the period of 1 min to 5 min after antigen challenge, and the apnea continued during the period of 30s to 22 min. Four dogs died during the period of 20 min to 30 min after antigen challenge. In both groups, RL increased significantly and Cdyn decreased significantly after antigen challenge.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估100%氧气人工通气治疗IgE介导的过敏反应的疗效,我们比较了控制通气犬与自主通气犬之一的存活率。将14只对犬毒素敏感的犬随机分为两组:自主呼吸组(S组,n = 8)和人工通气组(A组,n = 6)。所有犬均用戊巴比妥麻醉。在S组,所有犬以4 l.min-1的恒定氧流量自主呼吸。自主呼吸维持呼气末二氧化碳水平在40至50 mmHg之间。在A组,用泮库溴铵使犬麻痹,用100%氧气进行机械通气,并调整潮气量以维持呼气末二氧化碳水平在35至40 mmHg之间。在测量基线肺阻力(RL)、动态顺应性(Cdyn)和循环参数后,将猪蛔虫抗原静脉注射到体循环中以诱导IgE介导的过敏反应。抗原激发后连续记录120分钟的RL、Cdyn和循环参数。在整个研究过程中进行动脉血气分析。A组和S组的存活率分别为100%和50%。在S组的8只犬中,有7只在抗原激发后1分钟至5分钟内出现呼吸暂停,呼吸暂停持续30秒至22分钟。4只犬在抗原激发后20分钟至30分钟内死亡。两组在抗原激发后RL均显著增加,Cdyn均显著降低。(摘要截断于250字)