Domino K B, Emery M J, Swenson E R, Hlastala M P
Department of Anesthesiology, University of Washington, Seattle 98195-6540, USA.
Respir Physiol. 1998 Jan;111(1):89-100. doi: 10.1016/s0034-5687(97)00103-5.
Hypocapnia increases ventilation/perfusion (VA/Q) heterogeneity in dogs, possibly by adversely affecting distribution of ventilation through its effects on collateral ventilation. Because pigs lack collateral ventilation, we compared the effects of hypocapnia on ventilation heterogeneity in pentobarbital-anesthetized, mechanically-ventilated dogs and pigs. Simultaneous multiple breath washouts of helium and nitrogen were used to assess the uniformity of the ventilation distribution by the phase III (SnIII) method. Ventilation heterogeneity was partitioned into two components, e.g. convective-dependent inhomogeneity (cdi) and diffusive-convective-dependent inhomogeneity (dcdi). Pulmonary gas exchange was also measured in pigs by the multiple inert gas elimination technique. Ventilation heterogeneity was increased (P < 0.01) in hypocapnic dogs. Inspiration of CO2 decreased ventilation heterogeneity by decreasing dcdi (P < 0.01). In contrast, ventilation heterogeneity was not increased in hypocapnic pigs. However, hypocapnia increased VA/Q heterogeneity by 18% (P < 0.05) in pigs. We conclude that hypocapnia increases ventilation heterogeneity in dogs but not in pigs, most likely related to an interspecies difference in collateral ventilation.
低碳酸血症会增加犬的通气/灌注(VA/Q)不均一性,可能是通过其对侧支通气的影响而对通气分布产生不利作用。由于猪缺乏侧支通气,我们比较了低碳酸血症对戊巴比妥麻醉、机械通气的犬和猪通气不均一性的影响。采用氦气和氮气同步多次呼气末冲洗法,通过III期(SnIII)方法评估通气分布的均匀性。通气不均一性被分为两个部分,即对流依赖性不均一性(cdi)和扩散-对流依赖性不均一性(dcdi)。还通过多惰性气体消除技术测量了猪的肺气体交换。低碳酸血症的犬通气不均一性增加(P<0.01)。吸入二氧化碳通过降低dcdi降低了通气不均一性(P<0.01)。相比之下,低碳酸血症的猪通气不均一性并未增加。然而,低碳酸血症使猪的VA/Q不均一性增加了18%(P<0.05)。我们得出结论,低碳酸血症会增加犬的通气不均一性,但不会增加猪的通气不均一性,这很可能与侧支通气的种间差异有关。