Microvascular injury distal to unilateral pulmonary artery occlusion.
Microvascular injury distal to unilateral pulmonary artery occlusion.
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单侧肺动脉闭塞远端微血管损伤。
DOI：
10.1152/jappl.1981.51.4.845
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
Schulz,W
中科院分区：
文献类型：
--
作者：
JohnsonJr,RL;Cassidy,SS;Haynes,M;Reynolds,RL;Schulz,W
我们探讨了三个问题：1）水肿液是否在暂时性单侧肺动脉闭塞（TUPAO）的远端积聚; 2）如果是，其积聚的速度有多快; 3）它如何受到呼气末正压（PEEP）的影响？使用气管分流器，我们测量了肺毛细血管血流量（Qc），组织体积（Vt），和弥散量（DLCO）在每个肺与再呼吸方法。在12只狗中进行对照测量后，闭塞左肺动脉，并在闭塞4小时期间和闭塞释放后30分钟间隔重复测量。其中6只犬采用10 cmH 2 O PEEP通气。最后，取出肺，称重并固定用于组织学检查。TUPAO使无PEEP时左肺Vt增加29%，PEEP时左肺Vt增加59%。解除阻塞后，未接受PEEP的犬左肺Qc和DLCO在30 min内恢复至对照水平，但接受PEEP通气的犬即使取消PEEP，Qc和DLCO仍保持抑制状态。尸检时，两组犬的左肺重量均超过预期，但PEEP组犬的左肺重量明显更重。组织学检查证实支气管血管袖带伴水肿和出血。
We explored three questions: 1) does edema fluid accumulate distal to temporary unilateral pulmonary artery occlusion (TUPAO); 2) if so how rapidly does it accumulate; and 3) how is it affected by positive end-expiratory pressure (PEEP)? Using a tracheal divider we measured pulmonary capillary blood flow (Qc), tissue volume (Vt), and diffusing capacity (DLCO) in each lung with a rebreathing method. After control measurements in 12 dogs, the left pulmonary artery was occluded and measurements were repeated at intervals during 4 h of occlusion and 30 min after release of the occlusion. Six of the dogs were ventilated with 10 cmH2O PEEP. Finally the lungs were removed, weighed, and fixed for histology. TUPAO caused a 29% increase in Vt of the left lung without PEEP and a 59% increase with PEEP. After release of the occlusion, Qc and DLCO in the left lung returned to control levels within 30 min in dogs not on PEEP but remained depressed in dogs ventilated with PEEP even though PEEP was removed. At postmortem the left lung weighed more than expected in both groups of dogs but was significantly heavier in those on PEEP. Histology confirmed bronchovascular cuffing with edema and hemorrhage.