Effect of increasing perfluorocarbon dose on VA/Q distribution during partial liquid ventilation in acute lung injury.
Effect of increasing perfluorocarbon dose on VA/Q distribution during partial liquid ventilation in acute lung injury.
复制标题
急性肺损伤部分液体通气期间增加全氟化碳剂量对 VA/Q 分布的影响。
DOI：
10.1097/00000542-200104000-00018
复制
发表时间：
2001
期刊：
影响因子：
8.8
通讯作者：
Hlastala,MP
中科院分区：
文献类型：
--
作者：
Lim,CM;Domino,KB;Glenny,RW;Hlastala,MP
虽然部分液体通气（PLV）过程中的气体交换依赖于全氟碳液体，但全氟碳剂量对通气灌注（VA/Q）分布的影响尚不清楚。本研究探讨了增加全氟碳剂量对PLV期间急性损伤肺的VA/Q分布的影响。方法8只（3.2+/-0.1 kg）兔，经反复生理盐水灌洗（动脉氧分压/吸入氧分数，37+/-11 mm Hg）造成急性肺损伤（ALI）。在PLV期间，随机使用三种不同剂量的全氟萘（9 ml/kg=低剂量；13.5 ml/kg=中剂量；18 ml/kg=功能剩余容量[FRC]剂量）。采用多重惰性气体消除技术评价了不同剂量下的VA/Q分布。结果随着全氟碳剂量的增加，气体分流率（ALI为63+/-21%）下降（低剂量为43+/-21%，中剂量为29+/-10%，FRC剂量为11+/-9%，P= 0.022）。与ALI（0%）相比，低VA/Q单位比例在所有试验剂量下均较高（分别为19+/-10、25+/-12和34+/-18%，均P< 0.05）。与ALI（27+/-14%）相比，低、中剂量组正常VA/Q单位比例未增加，仅FRC剂量组增加（45+/-13%；P= 0.027）。结论随着全氟碳剂量的增加，分流从小剂量开始减少。大多数分流装置被转换成低VA/Q比的装置，而不是正常的VA/Q比。在不同剂量的全氟碳中存在相当数量的低VA/Q单位，这表明在PLV期间需要采取额外措施，以增强其对气体交换的影响。
BackgroundAlthough gas exchange during partial liquid ventilation (PLV) depends on perfluorocarbon liquid, the effect of perfluorocarbon dose on the ventilation-perfusion (VA/Q) distribution is not known. This study investigated how VA/Q distribution of an acutely injured lung is affected during PLV at increasing perfluorocarbon dose.MethodsIn eight rabbits (3.2+/-0.1 kg), acute lung injury (ALI) was created by repeated saline lavage (arterial oxygen partial pressure/fraction of inspired oxygen, 37+/-11 mm Hg). Three different doses of perfluorodecalin (9 ml/kg= low dose; 13.5 ml/kg= medium dose; 18 ml/kg= functional residual capacity [FRC] dose) were applied in random order during PLV. VA/Q distribution at different doses was evaluated by multiple inert gas elimination technique.ResultsInert gas shunt (63+/-21% at ALI) decreased with increasing perfluorocarbon dose (43+/-21% at low dose, 29+/-10% at medium dose, 11+/-9% at FRC dose; P= 0.022). Compared with ALI (0%), the proportion of low VA/Q units was higher at all tested doses (19+/-10, 25+/-12, and 34+/-18%, respectively; all P< 0.05). Compared with ALI (27+/-14%), the proportion of normal VA/Q units was not increased at low or medium doses but was increased only at the FRC dose (45+/-13%; P= 0.027).ConclusionsWith increasing perfluorocarbon dose during PLV, shunt was reduced from a small dose. The majority shunt units were converted to units showing low VA/Q ratios rather than normal VA/Q ratios. The presence of considerable amount of low VA/Q units across the varying doses of perfluorocarbon suggested that additional measures are necessary during PLV to augment its effect on gas exchange.