Type of lung injury influences the thermal-dye estimation of extravascular lung water.
Type of lung injury influences the thermal-dye estimation of extravascular lung water.
复制标题
肺损伤的类型影响血管外肺水的热染料估计。
DOI：
10.1152/jappl.1984.57.3.680
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Gray,BA
中科院分区：
文献类型：
--
作者：
Carlile,PV;Gray,BA
为了确定肺损伤类型对血管外肺水热稀释估计的影响，我们通过向肺循环注射四氧嘧啶或α-萘基硫脲（ANTU）或向气道滴注盐酸（HCI），在 25 只麻醉犬中产生肺水肿。 HCl 损伤为双侧、单侧且各肺潮气量相等或单侧气道压力相等。在基线和肺损伤后4小时测量血管外热容量（ETV），并将最终测量值与死后测定的血管外肺质量（ELM）进行比较。 15 只遭受 HCl 损伤的动物中，有 11 只的最终 ETV 低于基线测量值。所有 HCl 动物（第 I 组）的最终 ETV 与 ELM 的比率平均为 0.31 +/- 0.14，这与四氧嘧啶或 ANTU 损伤的动物（第 II 组）的值不同，为 1.04 +/- 0.14（P 小于 0.01）。两组中每克无血干组织的血管外肺水没有差异（I 组和 II 组分别为 8.1 +/- 1.2 和 8.7 +/- 2.6），表明肺损伤同样严重；然而，I 组的分流分数较低（P 小于 0.01）。 ETV/ELM 与组 I 的分流分数相关 (r = 0.70)，但与组 II 不相关 (r = 0.32)。这些发现表明，由于肺血流从水肿区域重新分布，ETV 低估了 HCl 损伤后的肺水。
To determine the effect of the type of lung injury on the thermodilution estimation of extravascular lung water, we produced pulmonary edema in 25 anesthetized dogs by injection of alloxan or alpha-naphthylthiourea (ANTU) into the pulmonary circulation or by instillation of hydrochloric acid (HCI) into the airway. HCl injury was bilateral, unilateral with tidal volume equal in each lung, or unilateral with equal airway pressure. Extravascular thermal volume (ETV) was measured at base line and 4 h after lung injury, and the final measurement was compared with the postmortem determination of extravascular lung mass (ELM). In 11 of 15 animals with HCl injury final ETV was less than the base-line measurement. The ratio of final ETV to ELM for all HCl animal (group I) averaged 0.31 +/- 0.14, which was different from the value for animals with alloxan or ANTU injury (group II), 1.04 +/- 0.14 (P less than 0.01). Extravascular lung water per gram of blood-free dry tissue was not different for the two groups (8.1 +/- 1.2 and 8.7 +/- 2.6 for I and II, respectively), indicating equally severe lung injury; however, shunt fraction was less in group I (P less than 0.01). ETV/ELM correlated with the shunt fraction for group I (r = 0.70) but not for group II (r = 0.32). These findings indicate that ETV underestimates lung water after HCl injury due to the redistribution of pulmonary blood flow away from edematous areas.