Effects of isoflurane on regional pulmonary blood flow during one-lung ventilation.
Effects of isoflurane on regional pulmonary blood flow during one-lung ventilation.
复制标题
异氟烷对单肺通气期间局部肺血流的影响。
DOI：
10.1093/bja/74.2.209
复制
发表时间：
1995
影响因子：
9.8
通讯作者：
A. Goetz
中科院分区：
文献类型：
--
作者：
J. Groh;G. Kuhnle;L. Ney;A. Sckell;A. Goetz
据报道异氟烷可抑制缺氧性肺血管收缩。然而，单肺通气和异氟醚对局部肺血流量（Qr）的影响尚未详细研究。因此，使用放射性核素标记的微球，我们测量了家兔（n = 8）在左侧卧位在静脉注射基线麻醉下的双肺和单肺通气期间以及在额外给予1.5%异氟烷期间的Qr。连续记录宏观血液动力学变量。异氟醚增加双肺通气时非依赖性肺血流量。单肺通气引起整个低氧肺的Qr均匀降低，与异氟醚给药无关（P < 0.001）。异氟醚可显著增加单肺通气时低氧肺的Qr（P < 0.05）。在所有阶段，Qr的上叶高于下叶在两个肺的等重力切片;腹背灌注梯度被发现在左上叶。我们得出的结论是，1.5%异氟烷增加了非依赖性肺的灌注，抑制了缺氧性肺血管收缩诱导的肺血流重新分布，并且不影响等重力灌注梯度。
Isoflurane has been reported to inhibit hypoxic pulmonary vasoconstriction. However, the effects of one-lung ventilation and isoflurane on regional pulmonary blood flow (Qr) have not been investigated in detail. Therefore, using radionuclide labelled microspheres we measured Qr in rabbits (n = 8) in the left lateral decubitus position during two- and one-lung ventilation under i.v. baseline anaesthesia and during additional administration of 1.5% isoflurane. Macrohaemodynamic variables were recorded continuously. Isoflurane increased non-dependent lung blood flow during two-lung ventilation. One-lung ventilation caused a homogeneous decrease in Qr throughout the hypoxic lung, irrespective of isoflurane administration (P < 0.001). However, isoflurane significantly augmented Qr of the hypoxic lung during one-lung ventilation (P < 0.05). During all phases, Qr of the upper lobe was higher compared with that in the lower lobe in isogravitational slices of both lungs; a ventrodorsal perfusion gradient was found in the left upper lobe. We conclude that 1.5% isoflurane increased perfusion of the non-dependent lung, inhibited hypoxic pulmonary vasoconstriction-induced redistribution of pulmonary blood flow and did not influence isogravitational perfusion gradients.