Keavey P M, Hasan A, Au J, Dark J H
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, UK.
Nucl Med Commun. 1997 Jan;18(1):38-43. doi: 10.1097/00006231-199701000-00008.
Lung injury is a well-documented adverse effect of cardiopulmonary bypass. The mechanism of injury is not fully understood, but pulmonary hypoxia may be a factor. Post-operative pulmonary epithelial permeability (PEP) in ventilated versus non-ventilated lungs was measured within 2 h of return to the intensive care unit using a 99Tcm-diethylenetriamine pentaacetate aerosol technique. A portable scintillation detector system was required. Sodium iodide detectors have been used previously with this technique but are cumbersome. This study used mini caesium iodide detectors (Oakfield Instruments, Oxon, UK), which can be attached directly to the patient and are more suited to the intensive care setting. The clearance half-time from lung to blood (T1/2LB) was measured in 31 patients (62 lungs). The mean (+/- S.E.M.) clearance half-times were 42.3 +/- 2.7 and 45.7 +/- 3.8 min for non-ventilated and ventilated lungs respectively, with a mean difference of 3.4 +/- 3.1 min (P > 0.05). We conclude that, using this technique, no significant difference in PEP is observed between ventilated and non-ventilated lungs in patients undergoing cardiopulmonary bypass.
肺损伤是体外循环中一种有充分文献记载的不良反应。损伤机制尚未完全明确，但肺缺氧可能是一个因素。在返回重症监护病房后2小时内，使用99锝-二乙三胺五乙酸气溶胶技术测量通气肺与未通气肺的术后肺上皮通透性（PEP）。这需要一个便携式闪烁探测器系统。碘化钠探测器此前已用于该技术，但较为笨重。本研究使用了微型碘化铯探测器（英国牛津郡奥克菲尔德仪器公司），它可以直接连接到患者身上，更适合重症监护环境。对31例患者（62个肺）测量了从肺到血液的清除半衰期（T1/2LB）。未通气肺和通气肺的平均（±标准误）清除半衰期分别为42.3±2.7分钟和45.7±3.8分钟，平均差异为3.4±3.1分钟（P>0.05）。我们得出结论，使用该技术，在接受体外循环的患者中，通气肺与未通气肺的PEP未观察到显著差异。
