Research of the Effects of New Ventilatory Therapy Using the Combination of PLV and NO to Neonates

PLV与NO联合新型通气治疗对新生儿的影响研究

• 批准号: 08671314
• 负责人: SAKAI Takeo
• 金额: $ 1.41万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671314/
• 关键词: Partial liquid vantilation; Respiratory distress syndrome; Nitrric oxide; High-frequency oscillatory; ventilation; Partial liquid ventilation; high frequency ocsillation; Liquid ventilation; Respinatoru distress syndrome; Newborn

Partial liquid ventilation (PVL) with perfluorocarbon (PFC) improves pulmonary gas exchange in the respiratory distress syndrome (RDS). Nitric oxide (NO) is an endothelium-derived relaxing factor in a gaseous form. When inhaled at low concentrations, it may relax constricted pulmonary vascular smooth muscle. We hypothesized the combination of PVL and NO can be more effective to the patients with RDS than when PVL or NO is used alone. Therefore, we conducted animal experiments to investigate this hypothesis. We made RDS animal model using newborn piglets by lung lavage with warm saline.First, the optimal volume of PFC was investigated, Functional residual capacity (FRC) of the animals were 26 ml before lavage and 14 ml after lavage. Lung compliance improved as the volume of PFC was increased from 5 ml/kg to 30 ml/kg in 5 ml increments. However, oxygenation and CO2 elimination worsened at the volume of 25 ml/kg and 30 ml/kg of PFC.These results led us to conclude 15-20 ml/kg, that is very close to FRC, maybe optimal dose of PFC to the patients with RDS.Second, we compared the effects of two different ventilation mode with PLV, which were conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV). During CMV, PLV was able to keep good oxygenation and ventilation. However, once CMV was changed to HFOV, arterial blood gas value worsened. And when animals were changed to CMV again after ventilated by HFOV, blood gas value showed improvement, From these results, we conclude that HFOV is not adequate ventilation mode for PLV.Third, we conducted the another experiment that investigated the mutual effects of the combination of NO and PLV.Oxygenation of piglets remarkably improved during the combination of PLV and NO compared with PLV only. However, we could not performed sufficient number of experiments, therefore, definitive conclusion was not able to be demonstrated here.

全氟化碳（PFC）部分液体通气（PVL）可改善呼吸窘迫综合征（RDS）患者的肺气体交换。一氧化氮（NO）是一种气体形式的内皮源性舒张因子。当吸入低浓度时，它可以放松收缩的肺血管平滑肌。我们假设PVL和NO联合使用比单独使用PVL或NO对RDS患者更有效。因此，我们进行了动物实验来研究这一假设。采用新生仔猪温盐水肺灌洗法建立RDS动物模型，首先研究肺灌洗前肺功能残气量（FRC）为26 ml，灌洗后为14 ml。肺顺应性随着PFC体积以5 ml增量从5 ml/kg增加至30 ml/kg而改善。结果表明，PFC的最佳剂量为15-20 ml/kg，与FRC相近。其次，比较了常规机械通气（CMV）和高频振荡通气（HFOV）两种不同通气模式对肺通气的影响。在CMV期间，PLV能够保持良好的氧合和通气。然而，一旦CMV改为HFOV，动脉血气值恶化。结果表明，HFOV通气模式对PLV的通气效果不理想。第三，我们进行了PLV和NO联合通气的交互作用研究，结果表明，与单纯PLV通气相比，PLV和NO联合通气显著提高了仔猪的氧合。然而，我们无法进行足够数量的实验，因此，无法在此证明确定性结论。

项目成果

堺 武男: "新生児の人口換気療法" 今日の治療指針. 752- (1997)

Takeo Sakai：《新生儿人工通气治疗》今日治疗指南752-（1997）。