Desflurane but Not Sevoflurane Impairs Airway and Respiratory Tissue Mechanics in Children with Susceptible Airways
Desflurane but Not Sevoflurane Impairs Airway and Respiratory Tissue Mechanics in Children with Susceptible Airways
复制标题
地氟烷而非七氟烷会损害气道敏感儿童的气道和呼吸组织力学
DOI：
10.1097/01.anes.0000299430.90352.d5
复制
发表时间：
2008
期刊：
影响因子：
8.8
通讯作者：
W. Habre
中科院分区：
文献类型：
--
作者：
B. V. von Ungern;S. Saudan;F. Peták;Z. Hantos;W. Habre
背景：尽管七氟烷和地氟烷具有支气管活性作用，但尚未在儿童中系统比较其对气道和呼吸组织力学的影响，特别是在气道易感性（AS）儿童中。本研究的目的是评估七氟烷和地氟烷麻醉期间有和没有AS的儿童的气道和呼吸组织力学。方法：对20例健康对照组（C组）和20例AS患儿（AS组）进行呼吸系统阻抗测定。在丙泊酚麻醉期间以及在吸入七氟醚和地氟醚1最低肺泡浓度期间，以随机顺序测定呼吸系统阻抗。通过模型拟合从呼吸系统阻抗谱确定气道阻力、组织阻尼和弹性。结果：AS组患儿呼吸阻抗参数明显高于C组。两组的七氟烷均轻微降低了气道阻力（C组和AS组分别为−7.0 ± 1.5%和−4.8 ± 2.4%）。相反，地氟烷导致气道阻力和组织力学参数升高，AS儿童的气道狭窄明显增加（C组和AS组的气道阻力分别为18.2 ± 2.8%和53.9 ± 5%; P < 0.001）。给药顺序和稳态浓度建立后的时间均不影响这些结果。结论：这些结果强调了地氟烷对气道的有害作用，特别是在具有敏感气道的儿童中，与七氟烷的一致有益作用形成对比，质疑地氟烷在AS儿童中的使用。
Background:Although sevoflurane and desflurane exert bronchoactive effects, their impact on the airway and respiratory tissue mechanics have not been systematically compared in children, especially in those with airway susceptibility (AS). The aim of this study was to assess airway and respiratory tissue mechanics in children with and without AS during sevoflurane and desflurane anesthesia. Methods:Respiratory system impedance was measured in healthy control children (group C, n = 20) and in those with AS (group AS, n = 20). Respiratory system impedance was determined during propofol anesthesia and during inhalation of sevoflurane and desflurane 1 minimum alveolar concentration in random order. Airway resistance, tissue damping, and elastance were determined from the respiratory system impedance spectra by model fitting. Results:Children in group AS exhibited significantly higher respiratory impedance parameters compared with those in group C. Sevoflurane slightly decreased airway resistance (−7.0 ± 1.5% vs. −4.8 ± 2.4% in groups C and AS, respectively) in both groups. In contrast, desflurane caused elevations in airway resistance and tissue mechanical parameters, with markedly enhanced airway narrowing in children with AS (18.2 ± 2.8% vs. 53.9 ± 5%; P < 0.001 for airway resistance in groups C and AS, respectively). Neither the order of drug administration nor the time after the establishment of their steady state concentrations affected these findings. Conclusions:These results emphasized the deleterious effects of desflurane on the airways, particularly in children with susceptible airways in contrast with the consistent beneficial effects of sevoflurane, questioning the use of desflurane in children with AS.
地氟烷的心血管和呼吸作用：地氟烷与异氟烷有何不同？
影响因子：
5.7
作者：
Warltier,DC;Pagel,PS
通讯作者：
Pagel,PS
影响因子：
8.8
作者：
Brown, RH;Wagner, EM
通讯作者：
Wagner, EM
影响因子：
3.3
作者：
HANTOS, Z;DAROCZY, B;FREDBERG, JJ
通讯作者：
FREDBERG, JJ