Respiratory impedance following bronchoscopic or surgical lung volume reduction for emphysema.
Respiratory impedance following bronchoscopic or surgical lung volume reduction for emphysema.
复制标题
因肺气肿而进行支气管镜或手术肺减容后的呼吸阻抗。
DOI：
10.1159/000086256
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Hoffman,Andrew
中科院分区：
文献类型：
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作者：
Ingenito,EdwardP;Tsai,LarryW;Mentzer,StevenJ;Jaklitsch,MichaelT;Reilly,JohnJ;Lutchen,Kenneth;Mazan,Melissa;Hoffman,Andrew
背景：用于实现肺减容（BLVR）的支气管镜方法目前正在进行临床试验，并将很快在临床上可用。了解手术减容治疗（LVRS）和BLVR对肺和胸壁生理学的不同影响将有助于医生为patient.Objectives选择最佳的方法：确定LVRS是否会对肺或胸壁生理学产生不利影响，在3个月的后续行动相对于BLVR在绵羊肺气肿的实验model of sheep emphysema.Methods：12只混种绵羊用木瓜蛋白酶治疗产生实验性肺气肿，并分为对照组，LVRS，BLVR治疗组。肺和胸壁阻抗测量0，5，和10厘米水柱呼气末正压在基线和3个月followup.Results：肺气肿与气道阻力增加，肺组织阻力和弹性下降，胸壁组织阻力增加。治疗后，与对照组相比，LVRS和BLVR组的肺弹性增加相当。结论：（1）实验性肺气肿持续木瓜蛋白酶暴露后，停止治疗后病情加重。(2)BLVR和LVRS在3个月随访时产生等同的肺和胸壁阻抗反应。(3)尽管LVRS与广泛的胸膜瘢痕形成相关，但对胸壁阻抗无不良影响。
Background:Bronchoscopic methods for achieving lung volume reduction (BLVR) are presently undergoing clinical trials, and will soon be clinically available. Understanding the differential effects of surgical volume reduction therapy (LVRS) and BLVR on lung and chest wall physiology will assist physicians in selecting an optimal approach for patients.Objectives:Determine whether LVRS adversely affects lung or chest wall physiology at 3-month follow-up relative to BLVR in an experimental model of sheep emphysema.Methods:Twelve mixed-breed sheep were treated with papain to produce experimental emphysema, and were divided into control, LVRS, and BLVR treatment groups. Lung and chest wall impedance was measured at 0, 5, and 10 cm H2O positive end-expiratory pressure at baseline and 3-month follow-up.Results:Emphysema was associated with increased airway resistance, decreased lung tissue resistance and elastance, and increased chest wall tissue resistance. Following treatment, equivalent increases in lung elastance occurred in the LVRS and BLVR groups compared to controls. LVRS did not adversely affect chest wall impedance despite causing extensive pleural scarring.Conclusions:(1) Experimental emphysema following prolonged papain exposure progresses after cessation of treatment. (2) BLVR and LVRS produced equivalent lung and chest wall impedance responses at 3-month follow-up. (3) LVRS did not adversely affect chest wall impedance despite being associated with extensive pleural scarring.