急性肺损伤家兔部分液体通气疗效的实验研究

目的　观察部分液体通气 (partialliquidventilation ,PLV)治疗肺灌洗诱导的急性肺损伤 (acutelungin jury ,ALI)家兔时 ,肺气体交换及血流动力学变化。方法　 12只成年健康新西兰兔 ,麻醉后气管切开生理盐水反复肺内灌洗 ,直至动脉氧分压 (PaO2 ) <10 0mmHg(13 33kPa)达 1h ,即为ALI。随机分为部分液体通气组及对照组 ,对照组以呼吸机行常规机械通气 ,PLV组动物于ALI后气管内灌入氟碳化合物 (FC32 80 ,3M) 15ml/kg ,补充剂量 4ml/(kg·h) ,每小时记录各参数 ,4h处死动物。结果　部分液体通气组PaO2 及动脉血氧饱和度 (SpO2 )显著改善 ,PaCO2 显著降低 ,而血流动力学在整个试验过程中基本维持恒定。结论　以氟碳化合物为呼吸媒介的部分液体通气可明显改善肺灌洗诱导的急性肺损伤家兔的肺气体交换 ,对血液动力学无明显影响。

Effects of partial liquid ventilation on acute lung injury in rabbits

Objective To observe the effect of partial liquid ventilation (PLV) with perfluorocarbon (PFC) on lung gas exchange and lung hemodynamic change in rabbits with surfactant depletion-induced acute lung injury (ALI). Methods Twelve rabbits were treated by lung lavage to partial pressure of oxygen in arterial blood(PaO 2) below 100 mmHg for one hour and were randomly divided into gas ventilation group (control group) and partial liquid ventilation group(PLV group). Rabbits in PLV group received PFC (FC-77) intratracheally at a dose of 15 ml/kg. The parameters of gas exchange and hemodynamics were measured before lung lavage, after lung lavage when the ALI was established, and 1 hour, 2 hours after ALI. Animals underwent euthanasia at the end of the study. Results Surfactant depletion induced by lung lavage formed a stable acute lung injury. PaO 2 and SpO 2 in PLV group significantly increased and PaCO 2 and PIP decreased synchronously. Less hemodynamic damage was observed in PLV group compared with animals in control group. Conclusion In rabbits with surfactant depletion-induced acute lung injury, partial liquid ventilation with perfluorocarbon improve gas exchange with less adverse hemodynamic effect.