DECREASED PULMONARY DAMAGE IN PRIMATES WITH INHALATION INJURY TREATED WITH HIGH-FREQUENCY VENTILATION
DECREASED PULMONARY DAMAGE IN PRIMATES WITH INHALATION INJURY TREATED WITH HIGH-FREQUENCY VENTILATION
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DOI：
10.1097/00000658-199309000-00012
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发表时间：
1993-09-01
影响因子：
9
通讯作者：
PRUITT, BA
中科院分区：
文献类型：
--
作者：
CIOFFI, WG;DELEMOS, RA;PRUITT, BA
目的本研究在灵长类动物吸入性损伤模型中比较两种形式的高频通气（HFV）和常规容量通气（CON），以确定呼吸模式是否是肺损伤的决定因素。经支气管镜诊断为吸入性损伤，需要机械通气支持的患者，显著降低死亡率。他们假设，减少呼吸模式引起的肺损伤是部分负责他们的临床result.Methods成年狒狒15随机三个呼吸模式（CON，高频流中断[HFFI]，或高频振荡通气[HFO]）中度烟雾损伤后。通气支持针对相同的生理终点。7d后处死动物，比较肺组织病理学改变。结果CON组和HFFI组均达到生理终点，而HFO组未达到生理终点。CON和HFFI之间的血流动力学变量无差异。尽管PO2、FlO2、AA梯度和PCO2相似，但CON的气压伤指数大于HFFI（p <0.05）。HFFI组肺实质损伤明显低于CON组（p = 0.03）和HFO组（p = 0.0008）。结论HFFI的预防性应用可显著降低吸入性损伤患者的呼吸道损伤，并为HFFI降低吸入性损伤患者的死亡率提供了一种解释。
Objective This study compared two forms of high-frequency ventilation (HFV) with conventional volume ventilation (CON) in a primate model of inhalation injury to determine whether ventilatory mode was a determinant of pulmonary damage.Summary Background Data The authors previously reported that the prophylactic use of high-frequency flow interruption in patients with bronchoscopically diagnosed inhalation injury requiring mechanical ventilatory support resulted in a significant decrement in mortality. They hypothesized that a reduction in ventilatory mode induced pulmonary damage was in part responsible for their clinical results.Methods Fifteen adult baboons were randomized to one of three ventilatory modes (CON, high-frequency flow interruption [HFFI], or high-frequency oscillatory ventilation [HFO]) after moderate smoke injury. Ventilatory support was tailored to the same physiologic endpoints. After 7 days, the animals were killed and pulmonary pathologic changes were scored and compared. Repetitive physiologic and biochemical data were compared using analysis of variance for repeated measures.Results Physiologic endpoints were achieved in CON and HFFI, but not in HFO. Hemodynamic variables did not diff er between CON and HFFI. The barotrauma index was greater in CON compared to HFFI (p < 0.05), despite similar PO2, FlO2, AA gradient, and PCO2. Animals treated with HFFI had significantly less parenchymal damage than those treated with CON (p = 0.03) or HFO (p = 0.0008).Conclusions The prophylactic use of HFFI led to a significant decrement in ventilatory mode induced pulmonary damage and offers an explanation for the decreased mortality in inhalation injury patients treated with HFFI.