Partial Paralysis with d‐Tubocurarine and the Ventilatory Response to>CO2: An Example of Respiratory Sparing?
Partial Paralysis with d‐Tubocurarine and the Ventilatory Response to>CO2: An Example of Respiratory Sparing?
复制标题
d-筒箭毒碱的部分麻痹和对 CO2 的通气反应：呼吸保护的一个例子？
作者：
T. Gal;T. C. Smith
6名健康志愿者静脉注射d-Tubocurarinc（dTe），以评估部分麻痹对CO2诱导反应的影响。每例受试者在−40分钟内接受0.2 mg/kg。由间隔10分钟的五次递增剂量组成。在>dTc给药期间，维持PETCO 2高于每个受试者静息水平6-7 μ g的等渗性睡眠。在给予>dTc之前，该刺激水平下的通气量为23.8 ± 1.1 I/min（平均值± SE）。是平时的三倍在每次剂量>dTc后4-6分钟期间测量的稳态分钟通气量没有显著降低;通气水平主要通过增加呼吸频率来维持，因为潮气量从平均1，550 ml显著下降至1，050 ml（P> 0.025）。CO2反应曲线的斜率变化在受试者之间差异很大。虽然对照斜率为2.65± 0.76 1/min/cm（平均值± SE），但部分硬化后降至1.50 ± 0.36 1/min/cm。两组间差异无显著性（P> 0.10）。当握力为控制的6%，肺活量为控制的52%，最大静态呼吸压为控制的35- 40%时，保持通气。然而，结果表明，重要的呼吸功能，如咳嗽，深呼吸，并在没有气管插管的情况下保持气道通畅的能力显着受损。
d-Tubocurarinc (dTe) was administered intravenously to six healthy unanesthetized volunteers to assess the effects of partial paralysis on ventilatory response to CO2. Each subject received during a −40-minute period 0.2 mg/kg. consisting of five incremental doses at intervals 10 minutes apart. Isohypereapnia with PETCO2 6–7 torr above each subject's resting level was maintained throughout>dTc administration. Ventilation at this level of stimulus was 23.8 ± 1.1 I/min (mean ± SE) before administration of>dTc. about three times resting levels. Steady-state minute ventilation measured during the period 4–6 minutes after each dose of>dTc failed to decrease significantly; the levels of ventilation were maintained principally by increased respiratory frequency, since tidal volumes declined significantly from an average of 1,550 ml to 1,050 ml (P> 0.025). Changes in the slope of the CO2-response curve varied widely among subjects. Although the control slope of 2.65± 0.76 1/min/torr (mean ± SE) was reduced to 1.50 ± 0.36 1/min/torr after partial curarization. the change was not significant (P< 0.10). Ventilation was maintained at a time when grip strength was 6 per cent of control, vital capacity was 52 per cent of control, and maximum static respiratory pressures were 35–40 per cent of control. Nevertheless, the results suggest significant impairment of vital respiratory functions such as coughing, deep breathing, and the ability to maintain a patent airway in the absence of endotracheal intubation.