Real-time visualization of partial liquid ventilation

由于内毒素并不一定能引起大鼠肺损伤，因此本实验采用盐酸气管内滴入法而非内毒素法建立大鼠急性肺损伤模型。为了阐明部分液体通气在治疗急性肺损伤中的功效，我们在大鼠肺损伤模型中可视化并形态学分析实时肺泡募集。一组接受盐酸吸入和机械气体通气急性肺损伤组（ALI，n=10），在酸吸入后90分钟开始接受盐酸吸入和氟碳部分液体通气（PLV，n=10），以及未进行酸吸入但进行机械气体通气的组（对照，n=5）。以白蛋白为示踪剂，在荧光显微镜下观察10个高倍视野（1080 × 790 μ m），测量肺泡平均数和最大功能肺泡直径 ...更多信息 吸酸后90 ~ 210 min每30 min给药一次d。结果显示，部分液体通气后立即出现明显的肺泡复张。肺损伤组每高倍视野下功能性肺泡数（31.2±8.9）明显低于对照组（144±11.9）。部分液体通气后30分钟，PLV组增加到102.1±17.6，实验结束时增加到130.3±19.1。最大功能肺泡直径由液体通气前的103.7±16.3 μ m降至液体通气后30分钟的86.5±7.4 μ m。该值进一步降低并保持恒定，直到实验结束，为76.3±6.5 um，与对照组（75.1±9.4 um）相当。PLV组肺湿重/干重比值小于ALI组。这些结果已在日本外科学会（2002）、日本胸科学会（2001）的年会上报道，并发表在《微循环年鉴》（2002）和《外科学》（2003）上。少

Acute lung inury rat model were induced by tracheal instillation of not endotoxin but hydrochloric acid in this study, because endotoxin could not always induce lung injury in each rat model. To clarify an efficacy of partial liquid ventilation in the treatment of acute lung injury, we visualized and morphologically analyzed real-time alveolar recruitment in a rat lung injury model.Male Wistar rats were divided into three groups : a group that underwent hydrochloric acid aspiration and mechanical gas ventilation (ALI, n=10), a group that underwent hydrochloric acid aspiration and partial liquid ventilation with perfluorocarbon beginning 90 mins after acid aspiration (PLV, n=10), and a group that did not undergo acid aspiration but that did undergo mechanical gas ventilation (Control, n=5). The average number of alveoli and the diameter of the largest functional alveoli in 10 high-power fields (1080 x 790 um) observed on fluorescence micrographs labeled albumin as a tracer, were measure … More d every 30 mins from 90 to 210 mins after the acid aspiration. Results showed that alveolar recruitment was marked immediately after partial liquid ventilation. Functional alveoli per high-power field decreased significantly in the ALI group (31.2±8.9), in comparison to that in the Control group (144±11.9). The number in the PLV group increased to 102.1±17.6 at 30 mins after partial liquid ventilation and to 130.3±19.1 until the end of the experiment. The diameter of the largest functional alveolus decreased from 103.7±16.3 um under mechanical gas ventilation before liquid ventilation to 86.5±7.4 um at 30mins after liquid ventilation. This value decreased further and remained constant until the end of the experiment at 76.3±6.5 um, which was equivalent to that in the Control group (75.1±9.4 um). Wet to dry lung weight ratios in the PLV group were smaller than those in the ALI group. The excellent alveolar recruitment suggests that liquid ventilation not only improves gas exchange but also ameliorates ventilator-associated lung injury.These results have been reported at the annual meetings of Japan Surgical Society (2002), Japanese Association for Thoracic Society (2001) and were published in Microcirculation Annual (2002) and Surgery (2003). Less