The Pathophysiology of Decompression Sickness and the Effects of Doppler Detectable Bubbles.
The Pathophysiology of Decompression Sickness and the Effects of Doppler Detectable Bubbles.
复制标题
减压病的病理生理学和多普勒可检测气泡的影响。
DOI：
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
M. Spencer
中科院分区：
文献类型：
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作者：
M. Powell;M. Spencer
摘要：超声气泡探测器的最佳使用需要了解减压后体内气相形成的各种病理生理后果。在本合同的后半部分，我们的研究主要集中在对多普勒超声气泡探测器所照亮的减压病的理解上。对中心静脉系统中气体量的研究表明，多普勒气泡检测器是非常灵敏的设备，能够检测少量分散的气体。虽然在心前区模式下可能无法检测到半径非常小的气泡，但该器械可以轻松检测到小于0.01 cc/kg/min的量。通过导管引入中心静脉系统的气体将引起右心室收缩压（RVSP）升高，因为气体栓塞肺血管。上升的程度是气体栓塞率的函数。高压减压后，RVSP因惰性气体栓塞而升高。假设处于稳定状态，则可以推导出任何RVSP所需的气体量。对于心前区IV级（绵羊），这是0.03 cc/kg/min。以0.03的速率注入气体（每根导管）既不会产生呼吸困难的体征，也不会在体动脉中检测到气泡（通过颈动脉上的多普勒探头）。与IV级或V级心前区气泡相关的较小的压力异常气泡（与导管产生的气泡相反）以及RVSP的相关增加通常会促进惰性气体动脉化。可能导致神经减压病。（作者）
Abstract : The optimal use of ultrasonic bubble detectors requires a knowledge of the various pathophysiological consequence of gas phase formation in the body following decompression. Our studies during the later portion of this contract have been focused primarily on an understanding of decompression sickness as illuminated by the Doppler ultrasonic bubble detector. Studies of the amount of gas in the central venous system have shown that the Doppler bubble detectors are quite sensitive devices which are capable of detecting small quantities of dispersed gas. While gas bubbles with a very small radius may not be detectable in the precordial mode, the device can easily detect amounts smaller than 0.01 cc/kg/min. Gas introduced into the central venous system by means of a catheter will elicit a rise in the right ventricular systolic pressure (RVSP) as the gas embolizes the pulmonary vasculature. The degree of rise is a function of the gas embolization rate. Following hyperbaric decompression, the RVSP is elevated by inert gas emboli. Assuming a steady state, the amount of gas needed for any RVSP can be deduced. For a precordial Grade IV (in sheep) this is 0.03 cc/kg/min. Gas injected (per catheter) at this 0.03 rate produce neither signs of dyspnea nor can bubbles be detected in the systemic arteries (by a Doppler probe on the carotid artery). The smaller dysbarogenic bubbles (in contrast to catheter-produced) in concert with Grade IV or Grade V precordial bubbles, and the associated increase in RVSP, will often promote inert gas arterialization. Neurologic decompression sickness could result. (Author)