Effects of pulmonary restriction on hypercapnic responses of heart-lung transplant recipients.
Effects of pulmonary restriction on hypercapnic responses of heart-lung transplant recipients.
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肺限制对心肺移植受者高碳酸血症反应的影响。
DOI：
10.1152/jappl.1991.71.1.322
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Theodore,J
中科院分区：
文献类型：
--
作者：
Duncan,SR;Kagawa,FT;Kramer,MR;Starnes,VA;Theodore,J
先前关于人类心肺移植受者（HLTX）高碳酸血症通气反应（HCVR）的研究得出了相互矛盾的结果。我们比较了限制性移植受者（HLTX-R）与肺功能正常受者（HLTX-N）和正常对照(C)的HCVR。HLTX-R表现出有限的潮汐体积响应，而他们的频率响应与其他受试者基本相同。据此，HLTX-R的HCVR （1.45 +/- 0.59 l.min-1）。与HLTX-N和C相比，Torr CO2（-1）显著降低（分别为2.90 +/- 0.55 vs 3.05 +/- 1.23） （P < 0.02）。尽管无疑存在更大的通气阻抗，HLTX-R （0.46 +/- 0.28 cmH2O）高碳时气道（口）闭塞压力反应（Pm0.1）与C（0.43 +/- 0.20）相似，与HLTX-N（0.83 +/- 0.36）相比反而变迟钝（P < 0.02）。我们得出结论，对于呼吸力学正常的HLTX患者，肺反射对于维持HCVR是多余的，而适度限制的存在会导致这些受试者的二氧化碳反应严重抑制。
Previous studies of hypercapnic ventilatory responses (HCVR) in human heart-lung transplant recipients (HLTX) have yielded conflicting results. We compared the HCVR of restricted transplant recipients (HLTX-R) to recipients with normal pulmonary function (HLTX-N), and normal controls (C). HLTX-R exhibited limited tidal volume responses, whereas their frequency responses were essentially identical to those of other subjects. Accordingly, HCVR of HLTX-R (1.45 +/- 0.59 l.min-1.Torr CO2(-1)) were significantly depressed compared with both HLTX-N and C (2.90 +/- 0.55 vs 3.05 +/- 1.23, respectively) (P less than 0.02). Despite undoubtedly greater ventilatory impedances, airway (mouth) occlusion pressure responses (Pm0.1) during hypercarbia of HLTX-R (0.46 +/- 0.28 cmH2O) were similar to those of C (0.43 +/- 0.20) and paradoxically blunted compared with HLTX-N (0.83 +/- 0.36) (P less than 0.02). We conclude that pulmonary reflexes are superfluous for maintenance of HCVR in HLTX with normal respiratory mechanics, whereas the presence of moderate restriction results in profound depression of CO2 responses among these subjects.