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Regional gas trapping during bronchoconstriction in the prone and supine positions

机译:在俯卧位和仰卧位的支气管中的区域气体捕获

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Airway closure and gas trapping are thought to occur during bronchoconstriction, but the magnitude and location of trapped gas regions are unknown. To examine this phenomenon, we imaged regional lung function in 12 (12/12 supine, 5/12 supine andprone) mechanically ventilated supine sheep (FIO{sub}2 = 0.5) before and one hour after intravenous infusion of methacholine (2.2-6.6 mg/hr) using positron emission tomography (PET). During steady state ventilatory conditions, mechanical ventilation wasstopped at end-exhalation, a bolus of 13{left sup}NN was infused intravenously, and intrapulmonary regional tracer content, proportional to perfusion, was imaged for 30 seconds. At that point, ventilation was restarted and regional specific ventilationwas assessed from the washout rate of the radio-labeled tracer. The fraction of perfusion into trapped regions was expressed as the ratio of the mean tracer content remaining after 1.5 minutes of ventilation to the initial tracer before the washout. Peakairway pressures increased from a mean of 20 to 36 cm H{sub}2O with methacholine infusion. Trapped tracer was always measured in the dorsal lung regions and ranged from 0.111 to 0.405 in the supine position (N = 12) and from 0.108 to 0.3505 (N = 5) in the prone position. We conclude that gas trapping with methacholine infusion occurs preferentially in the dorsal lung regions and appears to be minimally affected by changes in regional lung inflation caused by body position.
机译:在支气管混凝网中,据认为发生气道闭合和气体捕获,但陷阱气体区域的幅度和位置是未知的。为了检查这种现象,我们在12(12/12仰卧,5/12潜水柱)的区域肺功能之前,在静脉内输注甲素静脉内输注后1小时(2.2-6.6 Mg / hr)使用正电子发射断层扫描(PET)。在稳态通风条件下,在终止的机械通风时使得13 {左旋塞NN的推注静脉注射,并且对成比例的灌注区域示踪剂含量为30秒。此时,重新启动通风,并从无线电标记示踪剂的冲洗速率评估区域特定通气。灌注到捕获区域的分数表示为在洗涤外之前向初始示踪剂进行1.5分钟后留下的平均示踪剂含量的比率。峰值压力从20至36cm H {sub} 2o的平均压力增加,甲咯注入。捕获的示踪剂总是在背部肺部区域测量,并且在俯卧位(n = 12)中的0.111至0.405且在易于位置的0.108至0.3505(n = 5)。我们得出结论,含有甲素输注的气体捕获在背侧肺部区域中优先发生,似乎受到身体位置引起的区域肺充气变化的最小影响。

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