Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury
Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury
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DOI：
10.1164/rccm.200112-117oc
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发表时间：
2002-08-01
影响因子：
24.7
通讯作者：
Hlastala, MP
中科院分区：
文献类型：
--
作者：
Sinclair, SE;Kregenow, DA;Hlastala, MP
为了研究高碳酸性酸中毒是否对体内呼吸机诱导的肺损伤（VILI）有保护作用，我们对12只麻醉、瘫痪的家兔进行高潮气量通气（25cc /kg），每分钟32次呼吸，呼气末正压为零，持续4小时。每只兔随机接受FICO2治疗以达到高睡眠（Pa-CO2接近40 mm Hg， n = 6）或高碳酸性酸中毒（Pa-CO2 80-100 mm Hg, n = 6）。通过测量两组呼吸力学、气体交换、干湿质量、支气管肺泡灌洗液蛋白浓度和细胞计数以及损伤评分的差异来评估损伤。eucapnic组显示明显高于高原压力(27.0 + / - 2.5和20.9 + / - 3.0;p = 0.016),改变Pa-O2(165.2 + / - 19.4和77.3 + / - 87.9毫米汞柱;p = 0.02),湿:干重(9.7 + / - 2.3和6.6 + / - 1.8;p = 0.04),支气管肺泡灌洗蛋白质浓度(1350 + / - 228和656 + / - 511杯/毫升;p = 0.03),细胞计数(6.86 x 10 (5) + / - 0.18 x 10(5)和2.84 x 10 (5) + / - 0.28 x 10(5)有核细胞/毫升;P = 0.021)，损伤评分（7.0 +/- 3.3 vs 0.7 +/- 0.9; P < 0.0001）。我们得出结论，在这个模型中，高碳酸酸中毒对VILI有保护作用。
To investigate whether hypercapnic acidosis protects against ventilator-induced lung injury (VILI) in vivo, we subjected 12 anesthetized, paralyzed rabbits to high tidal volume ventilation (25 cc/kg) at 32 breaths per minute and zero positive end-expiratory pressure for 4 hours. Each rabbit was randomized to receive either an FICO2 to achieve eucapnia (Pa-CO2 similar to 40 mm Hg; n = 6) or hypercapnic acidosis (Pa-CO2 80-100 mm Hg; n = 6). Injury was assessed by measuring differences between the two groups' respiratory mechanics, gas exchange, wet:dry weight, bronchoalveolar lavage fluid protein concentration and cell count, and injury score. The eucapnic group showed significantly higher plateau pressures (27.0 +/- 2.5 versus 20.9 +/- 3.0; p = 0.016), change in Pa-O2 (165.2 +/- 19.4 versus 77.3 +/- 87.9 mm Hg; p = 0.02), wet:dry weight (9.7 +/- 2.3 versus 6.6 +/- 1.8; p = 0.04), bronchoalveolar lavage protein concentration (1,350 +/- 228 versus 656 +/- 511 mug/ml; p = 0.03), cell count (6.86 x 10(5) +/- 0.18 x 10(5) versus 2.84 x 10(5) +/- 0.28 x 10(5) nucleated cells/ml; p = 0.021), and injury score (7.0 +/- 3.3 versus 0.7 +/- 0.9; p < 0.0001). We conclude that hypercapnic acidosis is protective against VILI in this model.