应用无死腔气管插管提高正常和急性肺损伤兔的机械通气效率  

The effect of endotracheal tube without dead space on ventilation efficiency in rabbits with normal and injured lung

作　　者：陈贤楠[1] 耿荣[1] 吴冀川[1] 张锡沛[1] 樊寻梅[1] 

机构地区：[1]首都医科大学附属北京儿童医院危重病研究室

出　　处：《中国危重病急救医学》1997年第4期196-198,共3页Chinese Critical Care Medicine

基　　金：北京市科委课题资助

摘　　要：目的：观察无死腔气管插管能否提高急性呼吸衰竭常规机械通气的效果。方法：应用一种新型无死腔气管插管和普通聚氯乙烯气管插管对正常和急性肺损伤兔进行常规通气，对两种气管插管的肺气体交换和气道内气体动力学及血流动力学变化进行比较。无死腔气管插管用２根Ｐｏｔｅｘ气管插管远端３ｃｍ处纵切后对粘而成。５只新西兰成年兔，麻醉下气管切开，在持续应用潘龙阻断自主呼吸条件下，随机用新型气管插管和普通气管插管Ｓｅｒｖｏ９００Ｃ进行机械通气，每次持续３０分钟，测定并记录动脉血压、气道压力、血流动力学参数和呼气末ＣＯ２浓度。结果：在正常肺和急性肺损伤条件下，新型气管插管可使所有动物的ＰａＣＯ２和生理死腔／潮气量（ＶＤ／ＶＴ）下降，ＰａＣＯ２分别下降１．４０±０．２０ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）和１．６０±０．３０ｋＰａ（Ｐ＜０．０１），ＶＤ／ＶＴ分别下降０．１３±０．０２和０．１５±０．０４（Ｐ＜０．０１）；ＰａＯ２、气道压力和血流动力学无显著变化。结论：无死腔气管插管可明显提高常规机械通气效率。Objective:To determine whether use of endotracheal tube without dead space could improve mechanical ventilation efficiency after acute respiratory failure.Methods:A new endotracheal tube without dead space was designed and tested in rabbits with normal and injured lung.Ventilation efficiency of the new tube was compared with that of conventional endotracheal tube.Following anesthesia and tracheostomy,mechanical ventilation was performed by Servo 900C respirator,with 30 minutes each time.Arterial blood gases,airway pressure,hemodynamics and endexpiratory CO 2 were measured in animals.Results:It was shown that the new tube improved CO 2 removal in all animals.PaCO 2 was decreased by 1 40±0 20kPa(1kPa=7 5mmHg) and 1 60±0 30kPa( P <0 01).Physiological dead space/tideal volume (V D/V T) was reduced by 0 13±0 02 and 0 15±0 04( P <0 01) respectively.There was no significant changes in airway pressure and hemodynamics.Conclusions:The endotracheal tube without dead space significantly increases conventional ventilation efficiency in rabbits.

关 键 词：气管插管 无死腔 机械通气效果 肺损伤 

分 类 号：R563.8[医药卫生—呼吸系统] R459.7[医药卫生—内科学]