Wada K, Jobe A H, Ikegami M
Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California 90502, USA.
J Appl Physiol (1985). 1997 Oct;83(4):1054-61. doi: 10.1152/jappl.1997.83.4.1054.
We hypothesized that initiation of ventilation in preterm lambs with high volumes would cause lung injury and decrease the subsequent response to surfactant treatment. Preterm lambs were randomized to ventilation for 30 min after birth with 5 ml/kg (VT5), 10 ml/kg (VT10), or 20 ml/kg (VT20) tidal volumes and then ventilated with approximately 10 ml/kg tidal volumes to achieve arterial PCO2 values of approximately 50 Torr to 6 h of age. VT20 lambs had lower compliances, lower ventilatory efficiencies, higher recoveries of protein, and lower recoveries of surfactant in alveolar lavages and in surfactant that had decreased compliances when tested in preterm rabbits than VT5 or VT10 lambs. Other lambs randomized to treatment with surfactant at birth and ventilation with 6, 12, or 20 ml/kg tidal volumes for 30 min had no indicators of lung injury. An initial tidal volume of 20 ml/kg decreased the subsequent response to surfactant treatment, an effect that was prevented with surfactant treatment at birth.
我们假设，对早产羔羊进行高容量通气会导致肺损伤，并降低其随后对表面活性剂治疗的反应。将早产羔羊随机分为三组，出生后分别给予5 ml/kg（VT5）、10 ml/kg（VT10）或20 ml/kg（VT20）潮气量通气30分钟，然后以约10 ml/kg潮气量通气至6小时龄，使动脉血二氧化碳分压值达到约50 Torr。与VT5或VT10组羔羊相比，VT20组羔羊的顺应性更低、通气效率更低、蛋白质回收率更高、肺泡灌洗和表面活性剂中表面活性剂回收率更低，在早产兔中测试时顺应性降低。其他在出生时随机接受表面活性剂治疗并以6、12或20 ml/kg潮气量通气30分钟的羔羊没有肺损伤指标。初始潮气量为20 ml/kg会降低随后对表面活性剂治疗的反应，而出生时进行表面活性剂治疗可预防这种效应。
