Effects of mechanical ventilation and spontaneous respiration on hemodynamics in calves with total artificial hearts.
Effects of mechanical ventilation and spontaneous respiration on hemodynamics in calves with total artificial hearts.
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DOI：
10.1097/00002480-199207000-00083
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发表时间：
1992-07-01
期刊：
影响因子：
--
通讯作者：
Kiraly, R J
中科院分区：
文献类型：
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作者：
Fukamachi, K;Irie, H;Kiraly, R J
在4头安装人工心脏的荷斯坦犊牛上研究了呼吸对血流动力学的影响。电动液压驱动的E4 T-TAH具有连续往复式致动器，该致动器封装在两个交替喷射的被动填充血泵之间。当动物插管和机械通气时，测量血液动力学参数（右心房压力[RAP]、左心房压力[MAP]、肺动脉压力[PAP]、主动脉压力[AoP]）以及右和左泵充盈（Rt%充盈和Lt%充盈）。在动物拔管后，用自主呼吸重复这些测量。机械通气时，吸气时的呼吸阻力、肺动脉压和主动脉压均显著高于呼气时。然而，吸气时的RAP略低于呼气时。吸气期间的Rt%填充显著低于呼气期间，但吸气期间的Lt%填充显著高于呼气期间。在自主呼吸期间，这些变化与机械通气期间观察到的相反。机械通气在吸气时产生正胸内压，而自主呼吸产生负胸内压可能解释这些结果。静脉回流到右心房的变化导致RAP的变化与其他压力的变化方向相反。
The effects of respiration on hemodynamics were evaluated in four Holstein calves with total artificial hearts (TAH). The electrohydraulic actuated E4T-TAH has a continuously reciprocating actuator packaged between two alternately ejecting blood pumps that passively fill. The hemodynamic parameters (right atrial pressure [RAP], left atrial pressure [LAP], pulmonary artery pressure [PAP], aortic pressure [AoP]), and right and left pump filling (Rt% fill and Lt% fill) were measured when the animal was intubated and mechanically ventilated. These measurements were repeated with spontaneous respiration after the animal was extubated. With mechanical ventilation, LAP, PAP, and AoP were significantly higher during inspiration than during expiration. However, RAP during inspiration was slightly lower than that during expiration. The Rt% fill during inspiration was significantly lower than during expiration, but Lt% fill during inspiration was significantly higher than during expiration. During spontaneous respiration, these changes were opposite to those observed during mechanical ventilation. That mechanical ventilation generates positive intrathoracic pressure during inspiration, but spontaneous respiration generates negative pressure may explain these results. The change in venous return to the right atrium caused the change in RAP to be opposite in direction to that of the other pressures.