Improving oxygenation during bronchopulmonary lavage using nitric oxide inhalation and almitrine infusion
Improving oxygenation during bronchopulmonary lavage using nitric oxide inhalation and almitrine infusion
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DOI：
10.1097/00000539-199908000-00008
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发表时间：
1999-08-01
影响因子：
5.7
通讯作者：
Fischler, M
中科院分区：
文献类型：
--
作者：
Moutafis, M;Dalibon, N;Fischler, M
肺泡蛋白沉积症的治疗可能需要支气管肺泡灌洗。1966年（1）描述的这项技术可能与显著的氧合和血流动力学变化有关。通过压缩非通气肺的脉管系统，灌洗液可以减少流向肺的血流并使血流转向通气肺，从而由于低肺内分流而增加肺充盈阶段期间的Pao 2。当灌洗液从肺中排出时，肺血管系统不再被压缩，血流量增加。由于分流增加，肺排空会损害肺气体交换（2-4）。低氧血症可能非常严重，以至于支气管肺泡灌洗可能需要体外膜氧合（5，6）。新疗法，如一氧化氮（NO）和阿米三嗪，提供了一种治疗低氧血症的非替代性技术，特别是在单肺通气期间患有急性呼吸窘迫综合征和缺氧的患者中（7）。我们在一例支气管肺泡灌洗中使用了这些疗法。
The treatment of pulmonary alveolar proteinosis may require bronchopulmonary lavage. This technique, described in 1966 (1), can be associated with significant oxygenation and hemodynamic changes. By compressing the vasculature of the nonventilated lung, the lavage fluid can decrease blood flow to the lung and divert flow to the ventilated lung, consequently increasing Pao2 during the lung-filling phases because of a low intrapulmonary shunt. When the lavage fluid is drained from the lung, pulmonary vasculature is no longer compressed, and blood flow is increased. Emptying of the lung can then impair pulmonary gas exchange because the shunt increases (2–4).Hypoxemia can be so severe that bronchopulmonary lavage may require extracorporeal membrane oxygenation (5, 6). New therapeutics, such as nitric oxide (NO) and almitrine, provide a nonventilatory technique for treating hypoxemia, especially in patients suffering from acute respiratory distress syndrome and hypoxia during one-lung ventilation (7). We used these therapeutics in a case of bronchopulmonary lavage.