Walfisch S, Weksler N, Fisher A, Shapira Y
Department of Surgery C, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Isr J Med Sci. 1997 Jan;33(1):14-7.
The objective of our study was to investigate the influence on central and regional circulation of the application of positive end-expiratory pressure (PEEP=P) in a canine model of low hydrostatic pulmonary edema. Eight mongrel dogs with oleic acid-induced pulmonary edema were artificially ventilated with and without PEEP. Regional blood flow was determined using radioactive microspheres directly injected into the left ventricle. Regional blood flow to the brain was maintained under all experimental conditions, while the blood flow to the gastric fundal mucosa and to the pancreas significantly decreased following PEEP, oleic acid injection (OA) and with PEEP and oleic acid combination (P+OA). The renal blood flow decreased only during the P+OA phase. We conclude that the observed decrease in blood flow to the gastrointestinal mucosa and renal circulation in this acute low hydrostatic pressure pulmonary edema may correlate with the increased incidence of gastrointestinal and renal complications that accompany critically ill patients.
我们研究的目的是在低静水压性肺水肿犬模型中，探讨呼气末正压（PEEP = P）的应用对中心和区域循环的影响。八只油酸诱导肺水肿的杂种犬在有和没有呼气末正压的情况下进行人工通气。使用直接注入左心室的放射性微球测定区域血流量。在所有实验条件下，脑区域血流量均保持稳定，而在呼气末正压、注射油酸（OA）以及呼气末正压与油酸联合作用（P + OA）后，胃底黏膜和胰腺的血流量显著降低。肾血流量仅在P + OA阶段减少。我们得出结论，在这种急性低静水压性肺水肿中观察到的胃肠道黏膜和肾循环血流量减少，可能与重症患者伴随的胃肠道和肾脏并发症发生率增加有关。
