[肺泡气体成分在血流动力学紊乱期间的短暂变化(作者译)]。

J Santucci, B Le Bihan, G Barrès
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引用次数: 0

摘要

被动改变体位可引起血流动力学紊乱,尤其是心输出量减少。这在稳定状态下不涉及肺泡气体的任何改变。然而,本研究在恒定的通气和代谢状态下,PAO2和PACO2存在短暂的变化。血流动力学的干扰是由一个倾斜的座位,由正弦运动驱动,以不同的速度和恒定的振幅(90度)。根据伺服系统理论分析了系统的频率响应。结果表明,PAO2和PACO2的变化存在非线性的原因,PAO2的变化更为复杂,PAO2的变化幅度是PACO2的2 ~ 3倍。观察到的瞬态现象基本上被解释为由心输出量的动态行为差异引起的,另一方面是动静脉梯度的变化;这种影响在PAO2变异中更为明显。从实际的角度来看,在某些条件下,瞬态PAO2的大振幅变化(高达11 mmHg)可以通过单次连续记录到口腔的PO2来证明和确定辅助通气患者血流动力学障碍的到来时间。
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[Transient variations of alveolar gas composition during haemodynamic disturbances (author's transl)].

Passive changes in the posture induce haemodynamic disturbances, and especially a decrease of the cardiac output. This in the steady state does not involve any modification of the alveolar gas. There are however transient variations of PAO2 and PACO2, studied in this work at constant states of ventilation and metabolism. The haemodynamic disturbances are produced by a tip-up seat, actuated by a sinusoidal motion to different velocities and a constant amplitude (90 degrees). The frequency response is analyzed according to servosystems theories. The results show that there are causes of non-linearity in PAO2 and PACO2 variations, more complex for PAO2, and that the amplitude of the variations is two to three times greater for PAO2 than for PACO2. The observed transient phenomena are essentially interpreted as resulting from the differences in dynamic behavior between cardiac output on the one hand, variations in the arterio-venous gradient on the other; this effect is more pronounced for PAO2 variations. From a practical point of view, the great amplitude of transient PAO2 variations (as much as 11 mmHg) could, under certain conditions, allow, by the single continuous recording of PO2 to the mouth, to demonstrate and define the time of the arrival of an haemodynamic disturbance in patients with assisted ventilation.

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