当前位置: X-MOL 学术Vet. Anaesth. Analg. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Comparison of the efficacy of two ventilatory strategies in improving arterial oxygen tension and content in anaesthetized sheep.
Veterinary Anaesthesia and Analgesia ( IF 1.4 ) Pub Date : 2020-04-16 , DOI: 10.1016/j.vaa.2020.02.008
Luca Bellini 1 , Alessia Valentini 1 , Marco Bernardini 1
Affiliation  

Objective

To compare F-shunt and oxygen content indices in sheep ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH2O alone or preceded by a stepwise alveolar recruitment manoeuvre (ARM).

Study design

Randomized crossover design.

Animals

A total of six nonpregnant Brogna ewes weighing 34–47 kg, undergoing thoracolumbar magnetic resonance scan.

Methods

In medetomidine-sedated sheep, anaesthesia was induced with propofol and maintained with isoflurane 1.1% ± 0.1% and an inspired oxygen fraction (FiO2) of 0.4. Animals were placed in left lateral recumbency and, after 10 minutes of spontaneous breathing, mechanically ventilated with 5 cmH2O of PEEP with (group ARM) or without (group PEEP) a stepwise recruitment manoeuvre. Maintaining a fixed driving pressure of 15 cmH2O, PEEP was increased from 0 to 20 cmH2O every 3 minutes in 5 cmH2O increments. In each sheep, arterial blood samples were collected to measure arterial gases and to calculate F-shunt, PaO2/alveolar oxygen partial pressure (PAO2) and PaO2/FIO2 during spontaneous breathing before mechanical ventilation (T0), after 20 minutes of ventilation (T20) and during spontaneous breathing at extubation (Text).

Results

Both ventilatory strategies improved the arterial oxygen content although four animals in group PEEP showed oxygen content compatible with hypoxia compared with group ARM. F-shunt values were not statistically different at any time point in sheep that underwent only PEEP ventilation while they decreased at T20 and Text compared with T0 in group ARM. At extubation F-shunt was statistically lower in sheep that underwent an ARM. Mechanical ventilation improved PaO2/PAO2 and PaO2/FIO2 but they did not differ between groups.

Conclusions

and clinical relevance The stepwise ARM evaluated in this study improved oxygenation indices and decreased F-shunt. This effect was maintained at extubation compared with sheep that were ventilated with only PEEP 5 cmH2O.



中文翻译:

比较两种通气策略在麻醉羊中改善动脉血氧张力和含量的功效。

目的

为了比较单独使用呼气末正压(PEEP)5 cmH 2 O或先进行逐步肺泡募集操作(ARM)通风的绵羊的F分流和氧含量指标。

学习规划

随机交叉设计。

动物

总共六只体重34-47 kg的Brogna母羊接受了胸腰椎磁共振扫描。

方法

在美托咪定镇静的绵羊中,用异丙酚诱导麻醉,并维持1.1%±0.1%的异氟烷​​和0.4的吸入氧分率(F i O 2)。将动物置于左侧卧位,并在自发呼吸10分钟后,用5 cmH 2 O的PEEP进行机械通气,使用(ARM组)或不使用(PEEP组)逐步募集动作。保持15 CMH一个固定驱动压力2 O,PEEP从0增加至20 CMH 2每3分钟○在5个CMH 2个ö增量。在每只绵羊中,采集动脉血样本以测量动脉气体并计算F分流,PaO 2 /肺泡氧分压(PAO 2)和PaO 2 / FIO 2在机械通气前的自发呼吸(T 0),通气20分钟后(T 20)和拔管时的自发呼吸(T ext)。

结果

两种通气策略均改善了动脉血氧含量,尽管与ARM组相比,PEEP组的四只动物表现出的氧含量与低氧相容。仅进行PEEP通风的绵羊的F分流值在任何时间均无统计学差异,而在ARM组,在T 20和T ext与F 0相比,F分流值降低。拔管后,经过ARM手术的绵羊的F分流在统计学上较低。机械通气改善了PaO 2 / PAO 2和PaO 2 / FIO 2,但两组之间无差异。

结论

与临床相关性在这项研究中评估的逐步ARM改善了氧合指数并降低了F分流。与仅使用PEEP 5 cmH 2 O进行通风的绵羊相比,拔管时可以保持这种效果。

更新日期:2020-04-16
down
wechat
bug