Nitric oxide in partial liquid ventilation: better matching ventilation to perfusion in ARDS?
Nitric oxide in partial liquid ventilation: better matching ventilation to perfusion in ARDS?
复制标题
部分液体通气中的一氧化氮：ARDS 中通气与灌注的更好匹配？
DOI：
10.1007/s001340050306
复制
发表时间：
1997
影响因子：
38.9
通讯作者：
R. Rossaint
中科院分区：
文献类型：
--
作者：
U. Kaisers;R. Rossaint
重症监护医学（1997）23:139-140©Springer-Verlag 1997编辑全氟化碳的液相。此外，含氧全氟化学品中NO溶液分解过程中发生的反应尚不清楚。考虑到NO作为一种中间不稳定分子，容易以不同的氧化还原状态存在[8]，可以推测气态NO与体内含氧全氟化学品结合时会产生有毒化合物。在前瞻性临床应用之前，这些问题必须通过进一步的研究来澄清。目前，一氧化氮在部分液体通气条件下的累积效应机制尚不明确。由于全氟碳的密度高，是水的两倍，肺内液体分布不均匀，并遵循重力梯度，优先汇集在依赖肺泡。由于大量的氧气和二氧化碳溶解在全氟碳化合物中，气体交换也可能发生在这些充满液体的肺泡中。此外，全氟化学品具有很高的扩散系数和非常低的表面张力。在不依赖的、通风的肺区，化合物的薄层将降低液气界面的表面张力，从而改善肺的力学。有研究表明，部分液体通气对气体交换的有益作用部分是由于不可压缩液体填充和扩张肺泡，从而重新打开空气空间，防止它们发生呼气末塌陷。在ARDS中，这可能在肺的依赖区尤其如此，在那里肺扩张
Intensive Care Med (1997) 23: 139–140© Springer-Verlag 1997 EDITORIAL liquid phase of perfluorocarbons. Moreover, the reactions that occur during the solution decomposition of NO in oxygenated perfluorochemicals remain unclear. Considering NO as an intermediate and unstable molecule which easily exists in different redox states [8], it could be presumed that toxic compounds are generated when gaseous NO is combined with oxygenated perfluorochemicals in vivo. Prior to a prospective clinical application, these issues must be clarified by further investigations.At present, the mechanism responsible for the cumulative effects of NO in the setting of partial liquid ventilation remain speculative. Due to the high density of perfluorocarbons–twice as high as water, intrapulmonary distribution of the liquid is inhomogeneous and follows the gravitational gradient, preferentially pooling in dependent alveoli. Since significant amounts of oxygen and carbon dioxide are dissolved in perfluorocarbons, gas exchange might take place in these liquid-filled alveoli as well. Furthermore, perfluorochemicals have high spreading coefficients and remarkably low surface tensions. In non-dependent, ventilated lung regions, thin layers of the compounds will reduce the surface tension at liquid-gas interfaces and will thereby improve lung mechanics. It has been suggested that the beneficial effects of partial liquid ventilation on gas exchange are partly attributable to the filling and distending of alveoli with a non-compressible fluid, thereby reopening air spaces and preventing them from end-expiratory collapse [9]. In ARDS, this might be especially true in dependent zones of the lung, where the expanded lung
影响因子：
56.9
作者：
STAMLER, JS;SINGEL, DJ;LOSCALZO, J
通讯作者：
LOSCALZO, J
影响因子：
158.5
作者：
ROSSAINT, R;FALKE, KJ;ZAPOL, WM
通讯作者：
ZAPOL, WM