Durant体位和中心静脉抽吸对猪空气静脉栓塞的治疗效果

The effect of Durant position and aspiration via central venous catheter on air venous embolism in pigs

目的观察Durant体位和中心静脉抽吸对猪空气静脉栓塞的治疗效果。方法12头猪行纯氧机械通气,平卧体位下经股静脉以1ml/s的速度注入1ml/kg空气;间隔50min,再注入1ml/kg空气,并立即把猪改为头低左侧卧位(Durant体位);再间隔50min,平卧体位下再注入1ml/kg空气,2min后经中心静脉导管从右心房内抽吸,观察能否抽出气体。每次注气后连续观察经食管超声心动图图像、血压、肺顺应性、PETCO2变化。结果注射1ml/kg空气后,PETCO2和肺顺应性在Durant体位时下降的程度比平卧位相应时点显著降低(P<0.05或P<0.01),而两种体位时的收缩压差异无统计学意义。Durant体位时空气在心腔内的滞留时间显著长于平卧位,分别为(16±4)min与(12±3)min(P<0.05)。平卧位下注射1ml/kg空气后的2min,仅从两头猪的中心静脉中抽出4ml和6ml气体,其它10头猪未抽出气体。结论Durant体位对空气静脉栓塞有缓解作用,中心静脉抽吸治疗空气静脉栓塞效果欠佳。

Objective To observe the therapeutic effect of Durant position and aspiration via central veinous catheter on air venous embolism in pigs. Methods After anesthetized, twelve pigs were mechanically ventilated with 100% oxygen. 1 ml/kg air was injected via the femoral vein at a rate of l ml/s under supine position. At the interval of 50 min, same volume air was injected, then the pigs were put in Durant position immediately. The same volume of air was injected 50 min later, then aspiration was carried out via cental venous catheters with the tips in the right atrium. Transesophageal echocardiography, BP, PET CO2, lung compliance were continuously monitored. Results PET CO2 and lung compliance under Durant position were higher than those under supine position after air injection （P〈0.05 or P〈0.01）. The systolic pressure after air injection under the two kinds of position were not statistically different. The stay time of air in the heart was longer in Durant position than that in supine position[（16±4） min vs. （12±3） min,P〈0.05]. Only 4 ml and 6 ml of air were aspirated via central catheter in two of twelve pigs. Conclusion Durant position kept the air longer stay in the heart than supine position, but aspiration via central veinous catheters had less effect on the treatment of air venous embolism.