Effect of pulmonary edema on tracheal diameter.
Effect of pulmonary edema on tracheal diameter.
复制标题
肺水肿对气管直径的影响。
DOI：
10.1159/000029429
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
O'Donnell,DM
中科院分区：
文献类型：
--
作者：
Snapper,JR;Trochtenberg,DS;Hwang,YS;Lefferts,PL;Carroll,FE;Worrell,JA;O'Donnell,DM
背景心源性和非心源性肺水肿均可引起肺力学改变，但对气管直径的改变尚未见报道（心源性）和紫苏酮（PK;非心源性）方法：我们研究了两种不同类型的肺水肿对气管直径的影响，气管直径在慢性仪器清醒羊。心源性肺水肿（类似于人类的充血性心力衰竭）是通过充盈位于二尖瓣环中的Foley导管上的球囊以导致流经瓣膜的部分阻塞而增加左心房压力（↑ P LA）诱导的（n= 18）。非心源性肺水肿（肺微血管通透性增加肺水肿，类似于人类急性呼吸窘迫综合征）由PK静脉给药产生（n= 11）。侧位胸片（CXR）采用标准化5分评分系统对肺水肿的严重程度进行评分，并在隆突的固定位置测量气管直径。三名放射科医生，不知道绵羊识别号和实验方案，独立地评价了水肿严重程度和气管直径在不同时间点的X光片。结果肺湿/干重比（W/D ratio，W/D ratio，W/D ratio）与气管狭窄（P LA：20.3±0.6 ~ 15.1±0.9 mm; PK：20.2±0.6 ~ 14.1±1.4 mm）有统计学意义。气管狭窄与放射学确定的肺水肿严重程度相关（↑ P LA：r=-0.69，p< 0.01; PK：r=-0.62，p< 0.01）和W/D比值（↑ P LA：r=-0.64，p< 0.05; PK：r=-0.54，p< 0.05），但不影响正常工作。结论心源性和非心源性肺水肿绵羊模型均出现气管狭窄，狭窄程度与肺水肿程度有关。水肿的严重程度。
BackgroundThough it is well known that cardiogenic and noncardiogenic pulmonary edema can cause changes in lung mechanics, actual alterations in tracheal diameter have not been described.ObjectiveTo evaluate the effects of pulmonary edema induced by increased left atrial pressure (cardiogenic) and Perilla ketone (PK; noncardiogenic) on tracheal diameter in chronically instrumented awake sheep.MethodsWe investigated the effects of two mechanistically distinct types of pulmonary edema on tracheal diameter in chronically instrumented awake sheep. Cardiogenic pulmonary edema (analogous to congestive heart failure in humans) was induced by increasing left atrial pressure (↑ P LA) by inflating the balloon on a Foley catheter positioned in the mitral valve annulus to cause partial obstruction to flow across the valve (n= 18). Noncardiogenic pulmonary edema (increased pulmonary microvascular permeability pulmonary edema analogous to the acute respiratory distress syndrome in humans) was produced by the intravenous administration of PK (n= 11). Lateral chest radiographs (CXRs) were scored by a standardized 5-point scoring system for the severity of pulmonary edema, and tracheal diameter was measured at a fixed location in the carina. Three radiologists, blinded to sheep identification number and experimental protocol, evaluated the radiographs independently at different points in time for edema severity and tracheal diameter. The sheep were sacrificed immediately after the final CXR, and wet/dry lung weight ratio (W/D ratio) was determined.ResultsBoth↑ P LA and PK were associated with statistically significant tracheal narrowing (↑ P LA: 20.3±0.6 to 15.1±0.9 mm; PK: 20.2±0.6 to 14.1±1.4 mm). Tracheal narrowing correlated with the severity of the pulmonary edema determined radiographically (↑ P LA: r=–0.69, p< 0.01; PK: r=–0.62, p< 0.01) and by W/D ratio (↑ P LA: r=–0.64, p< 0.05; PK: r=–0.54, p< 0.05).ConclusionsWe conclude that tracheal narrowing occurs in sheep models of both cardiogenic and noncardiogenic pulmonary edema and that the degree of narrowing correlates with the severity of the edema.