PRONE POSITION ALTERS THE EFFECT OF VOLUME OVERLOAD ON REGIONAL PLEURAL PRESSURES AND IMPROVES HYPOXEMIA IN PIGS INVIVO
PRONE POSITION ALTERS THE EFFECT OF VOLUME OVERLOAD ON REGIONAL PLEURAL PRESSURES AND IMPROVES HYPOXEMIA IN PIGS INVIVO
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DOI：
10.1164/ajrccm/146.2.300
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发表时间：
1992-08-01
期刊：
影响因子：
--
通讯作者：
ALBERT, RK
中科院分区：
文献类型：
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作者：
MUTOH, T;GUEST, RJ;ALBERT, RK
当成人呼吸窘迫综合征患者和油酸诱导的肺损伤动物从仰卧位转为俯卧位时，氧合得到改善。在容量输注（VI）之前和之后，在仰卧位和俯卧位通气的六只猪中测量依赖性和非依赖性胸膜压力（Ppl）。 VI前，当动物仰卧时，平均+/- SEM AaPO 2差异为26 +/- 8 mm Hg，当动物俯卧时，平均+/- SEM AaPO 2差异为10 +/- 2 mm Hg（p > 0.05）。 VI后，当动物仰卧时AaPO 2为64 +/- 6 mm Hg（p < 0.05），当动物俯卧时为43 +/- 7 mm Hg（p < 0.05）。 当动物仰卧时，VI使Ppl梯度从0.53 +/-0.1增加到0.71 +/-0.1 cm H2O/cm（p < 0.05），当动物俯卧时，VI使Ppl梯度从0.17 +/-0.1增加到0.27 +/-0.1 cm H2O/cm（p < 0.05）。 当动物俯卧与仰卧时，FRC下的依赖性Ppl的阳性要少得多（0.9 +/- 0.3对3.0 +/- 0.5 cm H2，p < 0.05），表明这些依赖性区域中的气道将变窄和/或关闭，并且由于VI，这些区域的通气将减少。
Oxygenation improves in patients with adult respiratory distress syndrome and in animals with oleic acid-induced lung injury when they are turned from the supine to the prone position. Dependent and nondependent pleural pressures (Ppl) were measured in six pigs ventilated in the supine and prone positions before and after volume infusion (VI). Before VI the mean +/- SEM AaPO2 difference was 26 +/- 8 mm Hg when the animals were supine and 10 +/- 2 mm Hg when they were prone (p > 0.05). After VI the AaPO2 was 64 +/- 6 mm Hg when the animals were supine (p < 0.05) and 43 +/- 7 mm Hg when they were prone (p < 0.05). VI increased the Ppl gradient from 0.53 +/-0.1 to 0.71 +/- 0.1 cm H2O/cm when the animals were supine (p < 0.05) and from 0.17 +/- 0.1 to 0.27 +/- 0.1 cm H2O/cm when they were prone (p < 0.05). Dependent Ppl at FRC was much less positive when the animals were prone versus supine (0.9 +/- 0.3 versus 3.0 +/- 0.5 cm H2), p < 0.05), suggesting that the airways in these dependent regions would narrow and/or close and that ventilation to these regions would diminish as a result of VI.