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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2002年第3期

页码:

199-202

栏目:

实验研究

出版日期:

2002-05-01

文章信息/Info

Title:

Effects of positive/negative pressure ventilation on the lung haemodynamics and oxygeration of isolated perfused rabbit lungs

作者:

张洪伟¹;  曾泽戎²;  温光楠²;  贾　斌²;  原世麟²

第四军医大学: 1. 西京医院胃肠外科, 2. 病理生理学教研室, 陕西 西安 710032

Author(s):

ZHANG Hong-wei¹;  ZENG Zhe-rong²;  WEN Guang-nan²;  JIA Bin²;  YUAN Shi-lin²

1.Department of Gastrointestinal Surgery, Xijing Hospital, 2.Department of Pathophysiology, Fourth Military Medical University, Xi’an, Shaanxi 710032, China

关键词:

离体肺;  正压通气;  负压通气;  血流动力学

Keywords:

isolated perfused lung;  positive pressure ventilation;  negative pressure ventilation; hemodynamics

分类号:

Q463　

DOI:

-

文献标识码:

A

摘要:

目的 运用离体兔肺灌流模型(IPL)比较正、负压两种通气对肺循环血流动力学及通气效果的影响。方法 建立18只肺负压通气(NPV)的IPL模型,控制灌流液流量(133.33 ml/min)不变,在相同的潮气量及呼气末跨肺压下,对12只IPL更换为正压通气(PPV),20 min后重新进行NPV。在两种通气下,测定灌流压力(Pa)、回流压力 (Pv)、气道压力(Paw)、肺重量(LWt)等指标并连续同步描记。检测灌流液血氧分压(Po2)值。另6例IPL一直行NPV.结果 PPV可使Pa、肺血管阻力增高,LWt下降。PPV吸气时Pa增加,Pv下降,LWt略有上升;NPV吸气时Pa,Pv均下降,LWt显着增加。NPV时血氧增加幅度高于PPV。结论 本实验条件下PPV导致肺血管阻力增加;NPV的氧合效果优于PPV。

Abstract:

AIM To evaluate the effects of positive/negative pressure ventilation on pulmonary hemodynamic and oxygenation under the same tidal volume and end-expiratory transpulmonary pressure of isolated perfused rabbit lungs. METHODS 12 isolated perfused rabbit lung(IPL)models were set up at a constant perfusion flow (133.3 ml/min) and given negative pressure ventilation (NPV). Ventilation mood was changed into positive pressure ventilation (PPV) progressively under the same tidal volume and end-expiratory transpulmonary pressure (residual volume). 20 min later, ventilation mood was changed back to NPV. The changes in perfusion pressure(Pa) and venous pressure(Pv), airway pressure(Paw) and lung weight of IPL(LWt)were measured and monitored simultaneously and continuously on the recorder. Besides, the perfusate underwent blood gas analysis. 6 additional IPLs, which were similarly treated but not changed into PPV served as the control.RESULTS PPV increased the perfusion pressure and pulmonary vascular resistance and decreased the lung weight. Under PPV, Pa rose, Pv went down, and LWt increased slightly at the inhaling phase. However, when NPV was given, both the perfusion and venous pressures went down, and lung weight increased significantly at the inspiratory phase. The partial pressure of oxygen in perfusate increased much more significantly under NPV than under PPV.CONCLUSION Positive pressure in the airway affected alveolus vessels, and caused an increase in the pulmonary vascular resistance and the oxygenation of NPV might be better than that of PPV.

参考文献/References

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[8] Broccard AF, Hotchkiss JR, Suzuki S,et al.Effects of mean airway pressure and tidal excursion on lung injury induced by mechanical ventilation in an isolated perfused rabbit lung model[J].Crit Care Med, 1999,27:1533-1541.

备注/Memo

备注/Memo:

收稿日期：2001-10-15.

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更新日期/Last Update: 2005-05-01