Reber A, Engberg G, Wegenius G, Hedenstierna G
Department of Anaesthesiology, University Hospital, Uppsala, Sweden.
Anaesthesia. 1996 Aug;51(8):733-7. doi: 10.1111/j.1365-2044.1996.tb07885.x.
We have investigated the effect of pre-oxygenation and hyperoxygenation (an increase in inspired oxygen fraction from 0.4 to 1.0 after induction of general anaesthesia) on aeration and atelectasis formation in the lungs during total intravenous anaesthesia. Twenty-seven consecutive patients were randomly allocated to group 1 (with pre-oxygenation), group 2 (without pre-oxygenation), or group 3 (hyperoxygenation). Lung aeration was investigated by means of spiral computed tomography. The aeration of lung regions identified by computed tomography scans was divided into five categories: over-aeration, normal aeration, reduced aeration, poor aeration, and atelectasis formation. In group 1 larger areas of atelectasis were found in the basal parts of the lungs compared to group 2. In group 3 a significant increase in atelectatic areas with a corresponding reduction in areas with reduced aeration occurred at the bases of the lungs. The considerable increase in atelectasis associated with pre-oxygenation and its rapid appearance during hyperoxygenation suggest that these procedures should be used with caution.
我们研究了预给氧和高氧通气（全身麻醉诱导后吸入氧分数从0.4增加到1.0）对全静脉麻醉期间肺通气及肺不张形成的影响。连续27例患者被随机分配至第1组（预给氧组）、第2组（未预给氧组）或第3组（高氧通气组）。通过螺旋计算机断层扫描研究肺通气情况。计算机断层扫描识别出的肺区域通气分为五类：通气过度、通气正常、通气减少、通气不良和肺不张形成。与第2组相比，第1组在肺底部发现更大面积的肺不张。在第3组中，肺底部肺不张区域显著增加，通气减少区域相应减少。与预给氧相关的肺不张显著增加及其在高氧通气期间迅速出现表明，这些操作应谨慎使用。
