REGIONAL VENTILATION DURING SPONTANEOUS BREATHING AND MECHANICAL VENTILATION IN DOGS
REGIONAL VENTILATION DURING SPONTANEOUS BREATHING AND MECHANICAL VENTILATION IN DOGS
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DOI：
10.1152/jappl.1987.63.6.2467
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发表时间：
1987-12-01
影响因子：
3.3
通讯作者：
TONELLI, FM
中科院分区：
文献类型：
--
作者：
HUBMAYR, RD;RODARTE, JR;TONELLI, FM
我们评估了不同体位和呼吸模式下发生的不同胸壁变形模式对局部肺变形和通气的影响。使用肺实质标记物技术，我们确定了五只麻醉卧位犬在机械通气和自主呼吸过程中的局部肺行为。局部肺行为与功能残气量（FRC）和吸气末获得的X线投影图像估计的膈肌运动模式有关。结果表明：（1）俯卧位和仰卧位机械通气时的FRC大于自主呼吸时的FRC，（2）两种体位下机械通气和自主呼吸时的膈肌运动模式和区域通气模式存在显著差异，（3）仅仰卧位时FRC处存在垂直梯度，（4）机械通气时的FRC大于自主呼吸时的FRC，（5）机械通气时的FRC大于自主呼吸时的FRC。4）在两种位置和两种呼吸模式下，区域通气与肺叶和总肺容量的变化呈非线性相关; 5）不同的横膈膜运动模式导致上叶和下叶的不同滑动运动和不同旋转。我们的研究结果是不一致的经典模型的区域通气，我们的结论是，通气的分布是由一个复杂的相互作用的肺和胸壁的形状和运动的肺叶相对于彼此，所有这些都有助于尽量减少肺实质的扭曲。
We evaluated the effects of the different patterns of chest wall deformation that occur with different body positions and modes of breathing on regional lung deformation and ventilation. Using the parenchymal marker technique, we determined regional lung behavior during mechanical ventilation and spontaneous breathing in five anesthetized recumbent dogs. Regional lung behavior was related to the patterns of diaphragm motion estimated from X-ray projection images obtained at functional residual capacity (FRC) and end inspiration. Our results indicate that 1) in the prone and supine positions, FRC was larger during mechanical ventilation than during spontaneous breathing; 2) there were significant differences in the patterns of diaphragm motion and regional ventilation between mechanical ventilation and spontaneous breathing in both body positions; 3) in the supine position only, there was a vertical gradient in lung volume at FRC; 4) in both positions and for both modes of breathing, regional ventilation was nonlinearly related to changes in lobar and overall lung volumes; and 5) different patterns of diaphragm motion caused different sliding motions and differential rotations of upper and lower lobes. Our results are inconsistent with the classic model of regional ventilation, and we conclude that the distribution of ventilation is determined by a complex interaction of lung and chest wall shapes and by the motion of the lobes relative to each other, all of which help to minimize distortion of the lung parenchyma.