部分液体通气对急性肺损伤幼猪心肺功能的影响

Effect of partial liquid ventilation on cardiac and pulmonary function of acute lung injury in piglets

目的 研究部分液体通气对急性肺损伤幼猪心肺功能的影响。方法 12只上海小白猪，随机分为对照组（n=6）和治疗组（n=6）。内毒素60μg／kg静脉维持诱导肺损伤。治疗组成模后予高氟化碳（C10F18）10ml／kg灌入气管。于基础状态，成模时，成模后1、2、4h分别行血气分析、记录心率、血压、呼吸、肺动态顺应性、气道阻力、脉搏轮廓心输出量、全身血管阻力。结果 两组动物成模时氧合指数、肺动态顺应性、脉搏轮廓心输出量均明显下降，各参数组间比较无统计学差异。2h后对照组氧合指数193．8±47．5，肺动态顺应性（0．8±1．7）ml／（cmH2O·kg），4h后心输出量（2．1±0．7）L／min；治疗组2h后氧合指数为261．5±25．8，肺动态顺应性（1．2±0．7）ml／（cmH2O·kg），4h后心输出量（3．1±0．2）L／min，较对照组均有改善，差异有显著性（P〈0．05）。结论 部分液体通气可明显改善肺损伤动物心肺功能。

Objective To investigate the effect of partial liquid ventilation on cardiac and pulmonary function of endotoxin-induced acute lung injury of the piglets. Methods Twelve piglets were randomly divided into two groups： control group（ n = 6） and treatment group（ n = 6）. All the animals were given intravenous infusion of 60 μg/kg endotoxin to induce acute lung injury. When the oxygenation index〈 300 and pulmonary compliance〈 30 % of the baseline, the piglets of treatment group were given intratracheal infusion of C10F18 at the dosage of 10 ml/kg. The circulatory parameters[ heart rate （HR）, mean arterial blood pressure（MABP）, pulse contour cardiac output （PCCO） ; respiratory parameters： respiratory rate （RR）, pulmonary compliance （Cdyn）, resistance of airway （Rrs）, oxygenation index （OI） and arterial blood gas analysis] were measured and recorded at baseline, onset of ALI, one hour, two hours, four hours after ALI. Results The two groups showed no significant difference in circulatory parameters, respiratory parameters and blood gas analysis at baseline and onset of ALI. When the acute lung injury occurred, the two groups showed a decrease in oxygenation index, pulmonary compliance and pulse contour cardio output. After two hours of ALI, OI values of control group and treatment group were 193.8± 47.5 and 261.5±25.8 respectively; Cdyn were （0.8 ± 1.7） ml/ （cm H2O·kg） and （1.2±0.7） ml/（cm H2O·kg）.After four hours of ALI, PCCO values of the control and treatment group were （2.1 ± 0.7） L/min and （3.1 ± 0.2） L/min respectively. There was significant difference between the two groups（P 〈 0.05）. Conclusion Partial liquid ventilation has potent effect on cardic and pulmonary function of the piglets with endotoxin-induced acute lung injury.