气管内生理盐水对早产家兔动态肺-胸顺应性的影响。

A Oddoy, S Renner, O D Saugstad
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摘要

新生儿呼吸窘迫综合征的现代治疗方法是肺泡表面活性剂的替代。补充表面活性剂必须通过水乳液应用于肺。为了估计注入肺部液体的影响,总共使用了144只早产新生兔子。分别于妊娠27、28、29天(足月= 31±1天;平均+/- SD),麻醉(0.5 mg乙烷/kg b.w),麻痹(1mg泮库溴铵/kg b.w),正压通气(P = 25 hPa;F = 40/min;I:E = 1:1), 100%氧气。通过体容积描记术,在每kg b.w.气管内应用0(对照)、5、10或20 ml生理盐水(0.9% NaCl溶液)之前和之后90 min定期记录潮气量(VT)。动态肺-胸顺应性(Crs)以VT/P计算,并与体重相关。初始Crs值(平均+/- SD)分别为0.06 +/- 0.02 (27 d)、0.62 +/- 0.52 (28 d)和1.08 +/- 0.21 (29 d) ml/hPa/kg (p < 0.001)。经气管灌注生理盐水对妊娠第27天家兔新生儿Crs无明显影响。在妊娠第28或29天,Crs有短暂的(约15分钟)下降,随施液量的增加而增加。在给定的生理盐水量下,Crs降低的严重程度更多地取决于初始Crs值的大小,而不是妊娠日。(摘要删节250字)
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The influence of intratracheal saline upon the dynamic lung-thorax compliance of premature newborn rabbits.

A modern therapy for the respiratory distress syndrome in neonates is the substitution of alveolar surfactant. Supplementary surfactant has to be applied to the lung via an aqueous emulsion. To estimate the effects of fluids instilled into the lungs a total of 144 premature newborn rabbits were used. They were delivered by hysterotomy after 27, 28 or 29 gestational days (term = 31 +/- 1 days; mean +/- SD), anaesthetized (0.5 mg ethylurethane/kg b.w.), paralyzed (1 mg pancuronium bromide/kg b.w.) and ventilated by positive pressure (P = 25 hPa; f = 40/min; I:E = 1:1) with 100% oxygen. By means of body-plethysmography the tidal volume (VT) was recorded before and regularly during 90 min after the application of 0 (controls), 5, 10 or 20 ml saline (0.9% NaCl solution) per kg b.w. intratracheally. Dynamic lung-thorax compliance (Crs) was calculated as VT/P and related to the body weight. The initial Crs values (mean +/- SD) were 0.06 +/- 0.02 (27 days), 0.62 +/- 0.52 (28 days) and 1.08 +/- 0.21 (29 days) ml/hPa/kg, respectively (p less than 0.001). Intratracheal saline application had no detectable effect on Crs in rabbit neonates on day 27 of gestation. On day 28 or 29 of gestation there was a transient (approximately 15 min) Crs reduction, increasing with the volume of applied liquid. At a given saline quantity the severity of Crs reduction depended more on the magnitude of the initial Crs values than on the gestational day.(ABSTRACT TRUNCATED AT 250 WORDS)

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