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绵羊吸入烟雾后支气管循环减少对肺液体通量的影响。

Effect of reduced bronchial circulation on lung fluid flux after smoke inhalation in sheep.

作者信息

Sakurai H, Johnigan R, Kikuchi Y, Harada M, Traber L D, Traber D L

机构信息

Department of Anesthesiology, University of Texas Medical Branch and Shriners Burns Institute, Galveston, Texas 77555-0833, USA.

出版信息

J Appl Physiol (1985). 1998 Mar;84(3):980-6. doi: 10.1152/jappl.1998.84.3.980.

Abstract

We determined the effect of reduced bronchial blood flow on lung fluid flux through changes in lung lymph flow, lung wet weight-to-dry weight (wet/dry) ratios, and pulmonary microvascular reflection coefficient (sigma). In the first of two surgical procedures, Merino ewes (n = 21) were surgically prepared for chronic study. Five to seven days later, in a second operation, the bronchial artery of the injection group (n = 7) was ligated, and 4 ml of 70% ethanol were injected into the bronchial artery to cause sclerosis of the airway circulation. In the ligation group (n = 7), only the bronchial artery was ligated. In the sham group (n = 7), the bronchial artery was surgically exposed but left intact without ligation or ethanol injection. One day after these operations the animals received a tracheotomy and 48 breaths of cotton smoke. The value of sigma was determined at two points: 24 h before the second surgical procedure and 24 h after smoke inhalation. Lung lymph flow, blood-gas parameters, and hemodynamic data were measured every 4 h after injury. At the end of investigation, samples of lung were taken for determination of blood-free wet/dry ratio. In the sham group, inhalation injury induced a gradual increase in pulmonary vascular resistance and lung lymph flow, which was associated with deterioration of oxygenation. Reduction of the bronchial blood flow attenuated these pathophysiological changes, and the degree of this attenuation was greater in the injection group than in the ligation group. The value of sigma was significantly higher after smoke inhalation in the injection group compared with the sham group (0.77 +/- 0.04 vs. 0.61 +/- 0.03, means +/- SE) at 24 h. The mean wet/dry ratio value of the injection group animals was 30% less than that of the sham group. Our data show that the bronchial circulation contributes to edema formation in the lung occurring after acute lung injury with smoke inhalation.

摘要

我们通过观察肺淋巴流量、肺湿重与干重之比(湿/干比)以及肺微血管反射系数(σ)的变化,来确定支气管血流减少对肺液体通量的影响。在两项外科手术中的第一项手术中,对美利奴母羊(n = 21)进行手术准备以进行长期研究。五到七天后,在第二次手术中,结扎注射组(n = 7)的支气管动脉,并向支气管动脉内注入4毫升70%乙醇,以使气道循环硬化。在结扎组(n = 7)中,仅结扎支气管动脉。在假手术组(n = 7)中,手术暴露支气管动脉但不结扎或注射乙醇,使其保持完整。这些手术后一天,动物接受气管切开术并吸入48次棉烟。在两个时间点测定σ值:第二次外科手术前24小时和吸入烟雾后24小时。损伤后每4小时测量一次肺淋巴流量、血气参数和血流动力学数据。在研究结束时,取肺组织样本测定无血湿/干比。在假手术组中,吸入性损伤导致肺血管阻力和肺淋巴流量逐渐增加,这与氧合恶化有关。支气管血流减少减轻了这些病理生理变化,并且这种减轻程度在注射组比结扎组更大。与假手术组相比,注射组在吸入烟雾后24小时的σ值显著更高(0.77±0.04对0.61±0.03,均值±标准误)。注射组动物的平均湿/干比值比假手术组低30%。我们的数据表明,支气管循环在急性烟雾吸入性肺损伤后发生的肺水肿形成中起作用。

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