在不同身体位置的猪中,在单肺通风过程中,跨肺压力的分布
Jakob Wittenstein1, Martin Scharffenberg1, Xiuli Yang1,2
1Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus Dresden at Technische Universität Dresden, Dresden, Germany.
Frontiers in physiology
|August 21, 2023
概括
与双肺通风 (TLV) 相比,单肺通风 (OLV) 会增加肺部的压力. 虽然体位在OLV期间不会改变通风的肺应力,但半侧和侧侧位置会降低肺的稳定性.
科学领域:
- 生理学 生理学 生理学
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
背景情况:
- 在单肺通风 (OLV) 过程中,全球和区域的肺间压力 (PL) 尚不清楚.
- 在重症监护机构中,保护性低潮量通风策略至关重要.
- 了解体位在OLV期间对肺机械的影响对于患者安全至关重要.
研究的目的:
- 在OLV和双肺通风 (TLV) 期间调查全球和区域的肺间压力 (PL) 和驱动压力 (ΔPL).
- 为了确定不同的身体位置 (仰卧,半侧,侧侧,倾斜) 在OLV期间如何影响PL和ΔPL.
- 为了评估OLV期间的肺部不稳定性,在各种身体位置.
主要方法:
- 十六只幼猪接受了麻醉和仪器仪表,在腹部,背部和尾部区域设置了腹腔内压力传感器.
- 脂多糖被用于模拟炎症反应.
- 控制了通风参数 (潮流体积,PEEP),并在TLV和OLV期间在随机的身体位置进行测量.
主要成果:
- 与TLV相比,在卧卧的OLV期间,终端呼气PL和ΔPL是较高的.
- 在OLV期间,区域终端启发性PL和ΔPL在体位之间没有显著差异.
- 终端呼气PL较低,肺部不稳定性更频繁地发生在半侧和侧侧卧的位置,而不是躺着和倾斜的位置.
结论:
- 与双肺通风 (TLV) 相比,单肺通风 (OLV) 会增加肺部的压力.
- 在OLV期间,身体的位置不会显著改变在通风肺部的压力.
- 在OLV期间,在半侧和侧侧的位置上,肺部的稳定性受到损害.
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