Peritoneal ventilation in rabbits: Augmentation of gas exchange with cisapride
Peritoneal ventilation in rabbits: Augmentation of gas exchange with cisapride
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DOI：
10.1136/thx.51.1.82
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发表时间：
1996-01-01
期刊：
影响因子：
10
通讯作者：
Eshel, G
中科院分区：
文献类型：
--
作者：
Barr, J;Lushkov, G;Eshel, G
背景-在严重成人呼吸窘迫综合征(ARDS)的动物模型中，腹膜通气法已被证明能有效地实现肺外氧合和二氧化碳清除。西沙必利是一种促动力药(增加胃排空)，可增加内脏循环，从而有利于腹膜呼吸时的气体交换。方法：用多普勒超声观察西沙必利对8只自主呼吸兔门静脉循环的影响，并与5只自主呼吸室内空气的兔比较西沙必利对气体交换的影响。结果：西沙必利肠内给药后1h门静脉血流速度平均增加188%。在同时接受腹膜和肺部机械通气治疗的ARDS兔中，接受西沙必利治疗的兔的动脉血氧分压是对照组的1.5-3倍。西沙必利对自主呼吸室内空气的兔的动脉血氧分压无影响，对仅接受常规机械肺通气的ARDS兔也没有影响。结论：西沙必利增加了腹膜通气术治疗的严重ARDS兔的动脉血氧分压，可能与其增加内脏循环有关。应将其作为腹膜通气机的辅助用药。
Background - Peritoneal ventilation has been shown to be effective in achieving extrapulmonary oxygenation and carbon dioxide elimination in an animal model of severe adult respiratory distress syndrome (ARDS). Cisapride is a ''prokinetic'' agent (increases gastric emptying), that may increase the splanchnic circulation and thus favourably affect gas exchange in peritoneal ventilation.Methods - Using Doppler ultrasound the effect of cisapride on the portal venous circulation was examined in eight spontaneously breathing rabbits and the effect of cisapride on gas exchange in five rabbits spontaneously breathing room air was compared with that of a control group who did not receive cisapride. Its effect on gas exchange in five rabbits with ARDS being treated with mechanical lung and peritoneal ventilation was compared with that of a control group, and its effect on gas exchange in five rabbits with ARDS treated with conventional ventilation was also compared with that of a control group.Results - Enteral administration of cisapride increased portal venous blood velocity, as measured ultrasonographically, by a mean of 188% one hour after receiving the drug. In rabbits with ARDS being treated with both peritoneal ventilation and mechanical ventilation to the lungs, those receiving cisapride had arterial oxygen tensions 1.5-3 times that of controls. Cisapride had no effect on arterial blood gas tensions in rabbits who were spontaneously breathing room air, nor in rabbits with ARDS who received only conventional mechanical lung ventilation.Conclusions - Cisapride increases arterial oxygenation in rabbits with severe ARDS treated with peritoneal ventilation, probably due to its ability to increase splanchnic circulation. It should be considered as an adjuvant medication to peritoneal ventilation.