Isocapnic hyperventilation increases carbon monoxide elimination and oxygen delivery.
Isocapnic hyperventilation increases carbon monoxide elimination and oxygen delivery.
复制标题
等二氧化碳过度通气可增加一氧化碳的消除和氧气的输送。
DOI：
10.1164/ajrccm.163.2.2003039
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Hlastala,MP
中科院分区：
文献类型：
--
作者：
Kreck,TC;Shade,ED;Lamm,WJ;McKinney,SE;Hlastala,MP
长期以来，在动物和人类中，在低HbCO水平下，O2和CO2混合物的过度通气可以增强一氧化碳（CO）的消除。尚未研究这种疗法对氧输送（Do 2）的影响。采用机械通气的等碳酸血症过度通气可能会降低心输出量，从而降低Do 2，同时增加CO清除。我们研究了五只成年机械通气绵羊暴露于多次严重CO中毒的等二氧化碳过度通气的影响。研究了5种呼吸模式：基线每分钟通气量（RR · Vt）、2次（2 · RR）和4次（4 · RR）基线呼吸频率、2次（2 · Vt）和4次（4 · Vt）基线潮气量。RR · Vt的平均碳氧血红蛋白（HbCO）洗脱半衰期（t1/2）为14.3 ± 1.6 min，降至9.5 ± 1.5 min。 0.9 2 · RR为8.0 ± 0.5min，4 · RR为6.2 ± 0.5min，4 · Vt为5.2 ± 0.5min。与基线通气相比，过度通气期间的Do 2增加了2 · Vt，4 · RR和4 ·RR。 振动模式。在我们的动物模型中，等碳酸过度通气并没有改变动脉或肺动脉血压、动脉pH值或心输出量。等二氧化碳过度通气是一种很有前途的治疗CO中毒的方法。
Hyperventilation with mixtures of O2and CO2has long been known to enhance carbon monoxide (CO) elimination at low HbCO levels in animals and humans. The effect of this therapy on oxygen delivery (Do2) has not been studied. Isocapnic hyperventilation utilizing mechanical ventilation may decrease cardiac output and therefore decrease Do2while increasing CO elimination. We studied the effects of isocapnic hyperventilation on five adult mechanically ventilated sheep exposed to multiple episodes of severe CO poisoning. Five ventilatory patterns were studied: baseline minute ventilation (RR · Vt), twice (2 · RR) and four times (4 · RR) baseline respiratory rate, and twice (2 · Vt) and four times (4 · Vt) baseline tidal volume. The mean carboxyhemoglobin (HbCO) washout half-time (t1/2) was 14.3 ± 1.6 min for RR · Vt, decreasing to 9.5 ± 0.9 min for 2 · RR, 8.0 ± 0.5 min for 2 · Vt, 6.2 ± 0.5 min for 4 · RR, and 5.2 ± 0.5 min for 4 · Vt. Do2was increased during hyperventilation compared with baseline ventilation for 2 · Vt, 4 · RR, and 4 · Vtventilatory patterns. Isocapnic hyperventilation, in our animal model, did not alter arterial or pulmonary blood pressures, arterial pH, or cardiac output. Isocapnic hyperventilation is a promising therapy for CO poisoning.