Combining partial liquid ventilation with nitric oxide to improve gas exchange in acute lung injury
Combining partial liquid ventilation with nitric oxide to improve gas exchange in acute lung injury
复制标题
部分液体通气与一氧化氮相结合改善急性肺损伤的气体交换
作者：
R. Houmes;A. Hartog;S. Verbrugge;S. Böhm;B. Lachmann
目的：目的：探讨部分液体通气（PLV）过程中吸入一氧化氮（NO）浓度增加对急性肺损伤（ALI）猪的气体交换、血流动力学和氧转运的影响。设计：前瞻性实验研究。单位：实验重症监护病房的一所大学。受试者：6只诱导ALI的猪。干预：通过肺灌洗使动物表面活性剂耗尽至动脉血中的氧分压（PaO 2）< 100 mmHg。然后，他们接受了4次递增剂量的5 ml/kg perflubron（LiquiVent）。在每个剂量之间，动物接受0，10，20，30，40，和0百万分之一（ppm）NO。测量和主要结果：血气，血流动力学参数，和氧气输送后，每个剂量的perflubron以及每个NO浓度进行了测量。Perflubron导致PaO 2呈剂量依赖性增加。在每个perflubron剂量下，额外的NO吸入导致PaO 2进一步显著（ANOVA，p < 0.05）增加，在30 ± 10 ppm NO时效果最大。5 ml/kg perflubron剂量导致平均肺动脉压显著降低，随着NO浓度的升高，平均肺动脉压进一步降低。结论：PLV可以与NO给药组合，并导致对动脉氧合的累积效应和肺动脉压的降低，而对测量的全身血液动力学参数没有任何有害影响。
Objective: To assess the effects of increasing concentrations of inhaled nitric oxide (NO) during incremental dosages of partial liquid ventilation (PLV) on gas exchange, hemodynamics, and oxygen transport in pigs with induced acute lung injury (ALI). Design: Prospective experimental study. Setting: Experimental intensive care unit of a university. Subjects: 6 pigs with induced ALI. Interventions: Animals were surfactant-depleted by lung lavage to a partial pressure of oxygen in arterial blood (PaO2) < 100 mmHg. They then received four incremental doses of 5 ml/kg perflubron (LiquiVent). Between each dose the animals received 0, 10, 20, 30, 40, and 0 parts per million (ppm) NO. Measurements and main results: Blood gases, hemodynamic parameters, and oxygen delivery were measured after each dose of perflubron as well as after each NO concentration. Perflubron resulted in a dose-dependent increase in PaO2. At each perflubron dose, additional NO inhalation resulted in a further significant (ANOVA, p < 0.05) increase in PaO2, with a maximum effect at 30 ± 10 ppm NO. The 5 ml/kg perflubron dose led to a significant decrease in mean pulmonary artery pressure, which decreased further with higher NO concentrations. Conclusions: PLV can be combined with NO administration and results in a cumulative effect on arterial oxygenation and to a decrease in pulmonary artery pressure, without having any deleterious effect on measured systemic hemodynamic parameters.
全氟化碳相关的气体交换可改善肺力学、氧合、通气，并允许在发育不全的肺先天性膈疝羔羊模型中输送一氧化氮。
影响因子：
8.8
作者：
Wilcox,DT;Glick,PL;Karamanoukian,HL;Leach,C;Morin3rd,FC;Fuhrman,BP
通讯作者：
Fuhrman,BP
全氟化碳全液体通气可增加肺不张情况下的肺呼气末容积和顺应性。
影响因子：
8.8
作者：
Tooley,R;Hirschl,RB;Parent,A;Bartlett,RH
通讯作者：
Bartlett,RH