Endotoxemia increases relative perfusion to dorsal-caudal lung regions.
Endotoxemia increases relative perfusion to dorsal-caudal lung regions.
复制标题
内毒素血症增加背尾肺区域的相对灌注。
DOI：
10.1152/jappl.2001.90.4.1508
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发表时间：
2001
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;Altemeier,WA;Schimmel,C;Glenny,RW
急性肺损伤时灌注空间分布的变化及其对气体交换的影响尚不清楚。我们测试了内毒素血症是否引起灌注的地形差异，以及这些差异是否引起局部通气灌注比和气体交换的有意义的变化。区域通气和灌注进行了测量，在麻醉，机械通气的猪在俯卧位之前和期间内毒素血症与雾化和静脉荧光微球的使用。平均而言，内毒素血症期间，腹侧和颅侧肺区域的相对灌注减半，尾侧肺区域增加一倍，背侧肺区域增加1.5倍。相比之下，内毒素血症前灌注无地形差异，任何时间点通气无地形差异。因此，内毒素血症增加区域通气灌注比在尾-颅和背-腹方向，导致毛细血管末端Po 2值是显着低于背-尾比腹-颅区域。我们的结论是，肺血管对内毒素的反应存在地形差异，这可能对急性肺损伤的气体交换产生重要影响。
Changes in the spatial distribution of perfusion during acute lung injury and their impact on gas exchange are poorly understood. We tested whether endotoxemia caused topographical differences in perfusion and whether these differences caused meaningful changes in regional ventilation-to-perfusion ratios and gas exchange. Regional ventilation and perfusion were measured in anesthetized, mechanically ventilated pigs in the prone position before and during endotoxemia with the use of aerosolized and intravenous fluorescent microspheres. On average, relative perfusion halved in ventral and cranial lung regions, doubled in caudal lung regions, and increased 1.5-fold in dorsal lung regions during endotoxemia. In contrast, there were no topographical differences in perfusion before endotoxemia and no topographical differences in ventilation at any time point. Consequently, endotoxemia increased regional ventilation-to-perfusion ratios in the caudal-to-cranial and dorsal-to-ventral directions, resulting in end-capillary Po2values that were significantly lower in dorsal-caudal than ventral-cranial regions. We conclude that there are topographical differences in the pulmonary vascular response to endotoxin that may have important consequences for gas exchange in acute lung injury.
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