Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental respiratory distress syndrome: Dose‐dependent improvement of gas exchange
Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental respiratory distress syndrome: Dose‐dependent improvement of gas exchange
复制标题
气管内给予全氟化碳联合机械通气治疗实验性呼吸窘迫综合征：气体交换的剂量依赖性改善
作者：
A. Tütüncü;N. Faithfull;B. Lachmann
目的探讨气管内注入全氟化碳与常规机械通气联合应用对急性呼吸衰竭成年动物肺功能参数的影响。设计前瞻性、随机、安慰剂对照研究。单位：某大学麻醉学实验室。研究对象12只成年雄性新西兰兔。干预：反复生理盐水肺灌洗造成呼吸衰竭后，一组动物给予全氟化碳治疗，另一组给予生理盐水治疗作为对照组(n=6)。治疗包括气管内滴注递增剂量的每种液体3毫升/千克，直至总容量15毫升/千克。每次治疗剂量后机械通气15min，潮气量为12mL/kg，呼吸频率为30次/min，FiO2为1.0，呼气末正压为6cmH2O。测量方法和主要结果测定动脉血气和肺力学指标。全氟化碳组PaO2随剂量由75±15增加到420±27托(10.0±2.0至55.9±3.6千帕)，PaCO_2从49±6托(6.5±0.8至5.7±0.6千帕)降至43±5托(6.5±0.8至5.7±0.6千帕)，此后保持稳定。与治疗前相比，治疗后的气道压力显著降低。结论急性呼吸衰竭患者肺功能参数明显改善，提示全氟化碳治疗急性呼吸衰竭是一种有效、简便的方法。
ObjectivesTo test the efficacy of intratracheal instillation of a perfluorocarbon, combined with conventional mechanical ventilation, as well as to establish the dose response of this application on pulmonary parameters in adult animals with acute respiratory failure. DesignProspective, randomized, placebo-controlled study. SettingAnesthesiology laboratory of a university. SubjectsTwelve, adult male New Zealand rabbits. InterventionsAfter inducing respiratory failure by repeated lung lavage with saline, one group of animals was treated with perfluorocarbon, while another group was treated with saline to serve as controls (n = 6 per group). Treatment consisted of intratracheal instillation of incremental doses of 3 mL/kg of each liquid up to a total volume of 15 mL/kg. Animals were mechanically ventilated for 15 mins after each treatment dose with volume-controlled ventilation, a tidal volume of 12 mL/kg, frequency of 30 breaths/min, Fio2 of 1.0, and a positive end-expiratory pressure of 6 cm H2O. Measurements and Main ResultsArterial blood gases and lung mechanics were determined. In the perfluorocarbon group, Pao2 increased with increases in dosage from 75 ± 15 to 420 ± 27 torr (10.0 ± 2.0 to 55.9 ± 3.6 kPa) Paco2 decreased from 49 ± 6 to 43 ± 5 torr (6.5 ± 0.8 to 5.7 ± 0.6 kPa) after the first dose, and remained stable thereafter. Airway pressures were significantly lower after treatment compared with pre-treatment values. ConclusionThe remarkable improvements in pulmonary parameters suggest that this type of ventilatory support offers an effective and simple method of perfluorocarbon application in acute respiratory failure.