Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Tác động của hơi thở tự nhiên đối với hệ hô hấp ở hai mô hình khác nhau của tổn thương phổi thực nghiệm: một nghiên cứu kiểm soát ngẫu nhiên
Tóm tắt
Tổn thương phổi cấp (ALI) có thể xảy ra từ nhiều tác nhân khác nhau đến mô phổi. Dữ liệu từ thực nghiệm và lâm sàng cho thấy rằng hơi thở tự nhiên (SB) trong quá trình thông khí điều khiển áp suất (PCV) ở bệnh nhân ALI đem lại cải thiện về thông khí phổi và oxy hóa. Mục tiêu của chúng tôi là đánh giá xem việc bổ sung SB có tác động khác nhau trong hai mô hình ALI khác nhau hay không. Bốn mươi bốn con lợn được phân ngẫu nhiên thành ALI do hít phải acid hydrochloric (HCl-ALI) hoặc do tăng áp lực trong ổ bụng kết hợp với tiêm acid oleic qua tĩnh mạch (OA-ALI) và được thông khí theo chế độ PCV với hoặc không có SB (PCV + SB hoặc PCV - SB). Các biến số hô hấp và tim mạch đã được đo ở cơ sở sau khi khởi phát ALI và sau 4 giờ điều trị (PCV + SB hoặc PCV - SB). Cuối cùng, phân bố mật độ và thể tích phổi cuối kỳ thở ra (EELV) được đánh giá bằng chụp cắt lớp vi tính xoắn ốc ngực. PCV + SB cải thiện áp lực riêng phần của oxy động mạch/phân suất hít vào oxy (PaO2/FiO2) bằng cách giảm tỷ lệ shunt trong phổi ở HCl-ALI từ 27% ± 6% xuống 23% ± 13% và ở OA-ALI từ 33% ± 19% xuống 26% ± 18%, trong khi đó trong PCV - SB, PaO2/FiO2 xấu đi và tỷ lệ shunt tăng lên ở nhóm HCl từ 28% ± 8% lên 37% ± 17% và ở nhóm OA từ 32% ± 12% lên 47% ± 17% (P < 0.05 cho tương tác giữa thời gian và điều trị, nhưng không cho loại ALI). PCV + SB cũng dẫn đến EELV cao hơn (HCl-ALI: 606 ± 171 mL, OA-ALI: 439 ± 90 mL) so với PCV - SB (HCl-ALI: 372 ± 130 mL, OA-ALI: 192 ± 51 mL, với P < 0.05 cho tương tác giữa thời gian, điều trị và loại ALI). SB cải thiện quá trình oxy hóa, giảm tỷ lệ shunt và tăng EELV trong cả hai mô hình ALI.
Từ khóa
#tổn thương phổi cấp #hơi thở tự nhiên #thông khí điều khiển áp suất #oxy hóa #mô hình thực nghiệmTài liệu tham khảo
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