CONGENITAL HEART MALFORMATIONS AND VENTILATORY EFFICIENCY IN CHILDREN - EFFECTS OF LUNG PERFUSION DURING HALOTHANE ANESTHESIA AND SPONTANEOUS BREATHING
CONGENITAL HEART MALFORMATIONS AND VENTILATORY EFFICIENCY IN CHILDREN - EFFECTS OF LUNG PERFUSION DURING HALOTHANE ANESTHESIA AND SPONTANEOUS BREATHING
复制标题
DOI：
10.1093/bja/59.4.410
复制
发表时间：
1987-04-01
影响因子：
9.8
通讯作者：
OLSSON, AK
中科院分区：
文献类型：
--
作者：
LINDAHL, SGE;OLSSON, AK
对18例先天性心脏病患儿进行氟烷麻醉时自主通气的效率研究。其中，LR组10例，体重3.7 ~ 16 kg; RL组8例，体重3.4 ~ 12 kg。RL组每分钟通气量（VE）和潮气量（VT）均大于LR组（P < 0.05），而舒张率相近。两组动态顺应性和总肺阻力相同。根据动脉二氧化碳分压（PaCO 2）计算的肺泡通气量（VA）在两组中相同，而RL组相应的死腔通气量（VD）较高（P < 0.01）。VE/VCO 2和VD/VT比在肺血流量减少的儿童中高于在肺血流量增加的儿童中（分别为P < 0.05和P < 0.01），表明在右向左分流的儿童中气体交换效率较低。VT/TI比值升高（P < 0.01）和气道阻塞压升高（P < 0.05）反映了吸气驱动的增加。
The efficiency of spontaneous ventilation during halothane anesthesia was investigated in 18 infants and children with congenital heart disease presenting either with hyperperfusion and left-to-right shunt (group LR: n = 10, body weight 3.7-16 kg) or with hypoperfusion and right-to-left shunt (group RL: n = 8, body weight 3.4-12 kg). Minute ventilation (.ovrhdot.VE) and tidal volume (VT) were greater in group RL than in group LR (P < 0.05) while ventilatory rates were similar. Dynamic compliance and total pulmonary resistance were of the same magnitude in the two groups. Alveolar ventilation (.ovrhdot.VA) calculated from arterial carbon dioxide tensions (PaCO2) was the same in both groups while corresponding deadspace ventilation (.ovrhdot.VD) was higher in group RL (P < 0.01). .ovrhdot.VE/.ovrhdot.VCO2 and VD/VT ratios were higher in children with a diminished pulmonary blood flow than in children with an increased pulmonary blood flow (P < 0.05 and P < 0.01, respectively) indicating a less efficient gas exchange in children with a right-to-left shunt. This was compensated for by an increased inspiratory drive as reflected by higher VT/TI ratio (P < 0.01) and a more pronounced airway occlusion pressure (P < 0.05).