Sukumar M, Bommaraju M, Fisher J E, Morin F C, Papo M C, Fuhrman B P, Hernan L J, Leach C L
Division of Neonatology, Children's Hospital of Buffalo, State University of New York 14222, USA.
J Appl Physiol (1985). 1998 Jan;84(1):327-34. doi: 10.1152/jappl.1998.84.1.327.
Partial liquid ventilation using conventional ventilatory schemes improves lung function in animal models of respiratory failure. We examined the feasibility of high-frequency partial liquid ventilation in the preterm lamb with respiratory distress syndrome and evaluated its effect on pulmonary and systemic hemodynamics. Seventeen lambs were studied in three groups: high-frequency gas ventilation (Gas group), high-frequency partial liquid ventilation (Liquid group), and high-frequency partial liquid ventilation with hypoxia-hypercarbia (Liquid-Hypoxia group). High-frequency partial liquid ventilation increased oxygenation compared with high-frequency gas ventilation over 5 h (arterial oxygen tension 253 +/- 21.3 vs. 17 +/- 1.8 Torr; P < 0.001). Pulmonary vascular resistance decreased 78% (P < 0.001), pulmonary blood flow increased fivefold (P < 0.001), and aortic pressure was maintained (P < 0.01) in the Liquid group, in contrast to progressive hypoxemia, hypercarbia, and shock in the Gas group. Central venous pressure did not change. The Liquid-Hypoxia group was similar to the Gas group. We conclude that high-frequency partial liquid ventilation improves gas exchange and stabilizes pulmonary and systemic hemodynamics compared with high-frequency gas ventilation. The stabilization appears to be due in large part to improvement in gas exchange.
采用传统通气方案的部分液体通气可改善呼吸衰竭动物模型的肺功能。我们研究了高频部分液体通气在患有呼吸窘迫综合征的早产羔羊中的可行性，并评估了其对肺和全身血流动力学的影响。17只羔羊被分为三组进行研究：高频气体通气组（气体组）、高频部分液体通气组（液体组）和伴有低氧高碳酸血症的高频部分液体通气组（液体-低氧组）。与高频气体通气相比，高频部分液体通气在5小时内可提高氧合水平（动脉血氧分压253±21.3 vs. 17±1.8 Torr；P<0.001）。液体组的肺血管阻力降低了78%（P<0.001），肺血流量增加了五倍（P<0.001），主动脉压得以维持（P<0.01），而气体组则出现进行性低氧血症、高碳酸血症和休克。中心静脉压未发生变化。液体-低氧组与气体组相似。我们得出结论，与高频气体通气相比，高频部分液体通气可改善气体交换并稳定肺和全身血流动力学。这种稳定作用似乎在很大程度上归因于气体交换的改善。
