Correlation between ventilation and perfusion determines VA/Q heterogeneity in endotoxemia.
Correlation between ventilation and perfusion determines VA/Q heterogeneity in endotoxemia.
复制标题
通气和灌注之间的相关性决定了内毒素血症中 VA/Q 的异质性。
DOI：
10.1152/jappl.2000.88.6.1933
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Glenny,RW
中科院分区：
文献类型：
--
作者：
Gerbino,AJ;McKinney,S;Glenny,RW
内毒素增加了肺通气-灌注比（V˙a/Q˙）的异质性，但肺泡通气（V˙a）和灌注的确切变化导致V˙a/Q˙异质性尚不清楚。本研究的目的是确定内毒素如何影响通气和灌注的分布，以及这些变化对v˙a/Q˙异质性的影响。给予7头麻醉、机械通气的幼猪。采用雾化荧光微球和注射荧光微球同时检测大肠内毒素、局部通气和灌注。内毒素血症显著降低了区域通气与灌注的相关性，增加了灌注的异质性，并使灌注在肺区域之间重新分布。相比之下，通风的异质性没有改变，通风的再分配是适度的。与通气或灌注异质性的变化相比，局部通气和灌注之间相关性的降低导致了更大的v˙a/Q˙异质性。我们得出结论，在内毒素血症期间，V˙a/Q˙异质性增加主要是由于局部通气和灌注之间的相关性降低，而这主要是由灌注的变化决定的。
Endotoxin increases ventilation-to-perfusion ratio (V˙a/Q˙) heterogeneity in the lung, but the precise changes in alveolar ventilation (V˙a) and perfusion that lead toV˙a/Q˙heterogeneity are unknown. The purpose of this study was to determine how endotoxin affects the distributions of ventilation and perfusion and the impact of these changes onV˙a/Q˙heterogeneity. Seven anesthetized, mechanically ventilated juvenile pigs were givenE. coliendotoxin intravenously, and regional ventilation and perfusion were measured simultaneously by using aerosolized and injected fluorescent microspheres. Endotoxemia significantly decreased the correlation between regional ventilation and perfusion, increased perfusion heterogeneity, and redistributed perfusion between lung regions. In contrast, ventilation heterogeneity did not change, and redistribution of ventilation was modest. The decrease in correlation between regional ventilation and perfusion was responsible for significantly moreV˙a/Q˙ heterogeneity than were changes in ventilation or perfusion heterogeneity. We conclude that V˙a/Q˙heterogeneity increases during endotoxemia primarily as a result of the decrease in correlation between regional ventilation and perfusion, which is in turn determined primarily by changes in perfusion.