MEASUREMENT OF LUNG-VOLUME BY SULFUR-HEXAFLUORIDE WASHOUT DURING SPONTANEOUS AND CONTROLLED VENTILATION - FURTHER DEVELOPMENT OF A METHOD
MEASUREMENT OF LUNG-VOLUME BY SULFUR-HEXAFLUORIDE WASHOUT DURING SPONTANEOUS AND CONTROLLED VENTILATION - FURTHER DEVELOPMENT OF A METHOD
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DOI：
10.1097/00000542-198710000-00016
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发表时间：
1987-10-01
期刊：
影响因子：
8.8
通讯作者：
WERNER, O
中科院分区：
文献类型：
--
作者：
LARSSON, A;LINNARSSON, D;WERNER, O
描述并测试了一种用于测量麻醉和重症监护期间患者肺容量的开路示踪气体冲洗法。该方法采用了用于分配示踪气体、六氟化硫（SF6）的装置、快速SF6分析仪、呼吸速度计和计算机。分配装置将SF6与瞬时吸气流量成比例地输送到气道中，使得吸气SF6浓度保持恒定，通常为约0.5%，而与吸气流量模式无关。在洗出期间，从表示呼出SF6浓度和呼出流量的信号计算在洗入结束时存在于肺中的SF6的量。由此得出肺容积。准确和可重复的结果，在肺模型试验中获得的通风与空气，N2 O的O2，和氟烷的O2。在5例机械通气患者中，采用SF6冲洗和氮气冲洗两种方法测量功能残气量（FRC）。由此得到回归方程：FRCSF 6 = 10 ml + 1.04 ×FRCN 2，r = 0.99。在8名健康的、自主呼吸的受试者中观察到总肺容量（TLC）和残余容量（RV）测量的相似的接近的聚集：TLCSF 6 = 91 ml + 1.01 ×TLCN 2，r = 0.99; RVSF 6 = -32 ml + 0.97 ×RVN 2，r = 0.95。与8名健康的坐姿受试者的身体体积描记法比较，给出回归方程：FRCSF 6 = 180 ml + 0.96 ×FRCbox，r = 0.99。在10名麻醉、麻痹和机械通气的成人中，重复测定的变异系数中位数（范围）为3.0%（0.2-6.6%）。7名自主呼吸和7名人工通气麻醉儿童的相应数字分别为2.8%（0-7.6%）和0.6%（0.2-1.9%）。结论：该方法可用于自主呼吸和控制性通气。
An open circuit tracer gas washout method for measurement of lung volume in patients during anesthesia and intensive care is described and tested. The method employs a device for dispensing the tracer gas, sulfur hexafluoride (SF6), a fast SF6 analyzer, a pneumotachograph, and a computer. The dispensing device delivers SF6 into the airway in proportion to instantaneous inspiratory flow so that inspiratory SF6 concentration is held constant, usually at about 0.5%, regardless of the inspiratory flow pattern. The amount of SF6 present in the lungs at the end of a washin is calculated during washout from signals representing expired SF6 concentration and expired flow. From this, lung volume is derived. Accurate and reproducible results were obtained in lung model tests during ventilation with air, N2O in O2, and halothane in O2. Functional residual capacity (FRC) was measured both with SF6 washout and nitrogen washout in five mechanically ventilated patients. This gave the regression equation: FRCSF6 = 10 ml + 1.04 .times. FRCN2, r = 0.99. A similar close aggreement was observed for total lung capacity (TLC) and residual volume (RV) measurement in eight healthy, spontaneously breathing subjects: TLCSF6 = 91 ml + 1.01 .times. TLCN2, r = 0.99; RVSF6 = -32 ml + 0.97 .times. RVN2, r = 0.95. Comparison with body plethysmography in eight healthy, sitting subjects gave the regression equation: FRCSF6 = 180 ml + 0.96 .times. FRCbox, r = 0.99. The median (range) for the coefficient of variation at duplicate determinations in 10 anesthetized, paralyzed, and mechanically ventilated adults was 3.0% (0.2-6.6%). The corresponding figures for seven spontaneously breathing and seven manually ventilated, anesthetized children were 2.8% (0-7.6%) and 0.6% (0.2-1.9%), respectively. It is concluded that the method can be used during both spontaneous breathing and controlled ventilation.