頁籤選單縮合
題名 | Ventilation and Perfusion Distribution during Altered PEEP in the Left Lung in the Left Lateral Decubitus Posture with Unchanged Tidal Volume in Dogs |
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作者姓名(外文) | Chang, Hung; Lai-Fook, Stephen J.; Domino, Karen B.; Hildebrandt, Jack; Robertson, H. Thomas; Glenny, Robb W.; Hsu, Jane-yi; Lee, Shih-chun; Hlastala, Michael P.; | 書刊名 | 中國生理學雜誌 |
卷期 | 49:2 民95.04 |
頁次 | 頁74-82 |
分類號 | 398.4 |
關鍵詞 | Gas exchange; Lung mechanics; Fluorescent microspheres; Regional pulmonary blood flow distribution; |
語文 | 英文(English) |
英文摘要 | Previous studies in anesthetized humans positioned in the left lateral decubitus (LLD) posture have shown that unilateral positive end-expiratory pressure (PEEP) to the dependent lung produce a more even ventilation distribution and improves gas exchange. Unilateral PEEP to the dependent lung may offer special advantages during LLD surgery by reducing the alveolar-to-arterial oxygen pressure difference {(A-a)P□ or venous admixture} in patients with thoracic trauma or unilateral lung injury. We measured the effects of unilateral PEEP on regional distribution of blood flow (Q) and ventilation (□) using fluorescent microspheres in pentobarbital anesthetized and air ventilation dogs in left lateral decubitus posture with synchronous lung inflation. Tidal volume to left and right lung is maintained constant to permit the effect on gas exchange to be examined. The volume to left and right lung is maintained constant to permit the effect on gas exchange to be examined. The addition of unilateral PEEP to the left lung increased its FRC with no change in left-right blood flow distribution or nervous admixture. The overall lung □/Q distribution remained relatively constant with increasing unilateral PEEP. Bilateral PEEP disproportionately increased FRC in the right lung but again produced no significant changes in venous admixture or □/Q distribution. We conclude that the reduced dependent lung blood flow observed without PEEP increases dependent lung volume with little effect of perfusion distribution maintaining gas exchange. |
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