小潮气量机械通气对海水淹溺急性肺损伤兔治疗作用的实验研究

目的 观察小潮气量机械通气在海水淹溺急性肺损伤应用时的治疗作用和安全性.方法 分别应用潮气量为6 ml/kg和12 ml/kg的机械通气对海水淹溺急性肺损伤兔进行分组救治.在不同时间点检测血气分析、呼吸动力学、血液动力学,观察血清和肺泡灌洗液肿瘤坏死因子a、白介素6以及肺HRCT变化,并进行肺病理学检查,以评价治疗效果和安全性.结果 采用6 ml/kg小潮气量机械通气不仅能改善SWD-ALI时的氧合,而且能有效控制气道峰压和气道平均压,从而在一定程度上避免呼吸机相关肺损伤.结论 小潮气量保护性机械通气策略应用治疗海水淹溺急性肺损伤兔,能够明显改善氧合,避免继发肺损伤,是一种安全有效的治疗海水淹溺急性肺损伤的机械通气手段.

Effect of mechanical ventilation with low tidal volume on acute lung injury induced by seawater drowning in rabbits

Objective To observe the therapeutical effect and safety of mechanical ventilation with low tidal volume on acute lung injury induced by seawater drowning(SWD-ALI). Methods SWD-ALI rabbits received mechanical ventilation with different tidal volume (6 ml/kg or 12 ml/kg). Blood gas analysis, pneumodynamics, hemodynamies status were detected at various time points. Tumor necrosis factor-a and interleukin-6 in serum and bronchoalveolar lavage fluid were measured after treatment. High resolution computerized tomography and pathology examination were taken in each group. Remits Mechanical ventilation with low tidal volume (6 ml/kg) improved oxygenation, controlled peak inapiratory pressure and average in airway pressure in SWD-ALI, which avoided ventilator associated lung injury in some degree. Conclusions Protective lung ventilation strategy can obviously improve oxygenation, avoid secondary lung injury, and is an effective and safe ventilation approach in SWD-ALI treatment.