比较无辅助自主呼吸(SB)和完全肌肉麻痹(PC)对早期严重急性呼吸窘迫综合征(ARDS)动物模型的影响。探讨双相气道正压通气(BIPAP)作为重度ARDS早期患者肺保护性通气支持的可能性。
将12只10至15月龄的健康比格犬随机分为两组:SB组(BIPAPSB)和PC组(BIPAPPC)。在建模前抽取动脉血样。进行了动脉血气分析和机械测试。采用深静脉注射油酸建立重度ARDS动物模型,BIPAP通气8小时。取肺组织和血液检测肺功能,炎症反应和病理损伤程度。
实验开始时,两组之间的动脉血气分析差异无统计学意义(p>0.05)。建模成功后,MV后8小时,SB组的氧合指数和呼气末肺容积明显高于PC组。病理上,PC组湿干比、病理评分均高于SB组;SB组重力依赖区肺损伤小于PC组(p<0.05)。
在油酸诱导的严重ARDS的早期阶段,与PC相比,保留SB的BIPAP模式可以降低肺损伤的风险并改善呼吸功能。
To compare the effects of unassisted spontaneous breathing (SB) and complete muscle paralysis (PC) on early severe acute respiratory distress syndrome (ARDS) in an animal model, and to explore the possibility of biphasic positive airway pressure (BIPAP) as lung protective ventilation support for patients in the early stage of severe ARDS.
Twelve healthy beagle dogs between the ages of 10 and 15 months were randomly divided into two groups: the SB group (BIPAPSB) and the PC group (BIPAPPC). Arterial blood samples were drawn before modelling. Arterial blood gas analysis and mechanical tests were conducted. The animal model of severe ARDS was established using a deep intravenous injection of oleic acid, and BIPAP ventilation was performed for 8 hours. Lung tissue and blood were taken to detect lung function, inflammatory reactions and degree of pathological damage.
At the beginning of the experiment, there was no significant difference in the arterial blood gas analysis between the two groups (p > 0.05). After successful modelling, the oxygenation index and the end-expiratory lung volume in the SB group were significantly higher than those in the PC group 8 hours after MV. Pathologically, the wet-dry ratio and pathological score of the PC group were higher than those of the SB group; the lung injury in the gravity-dependent area in the SB group was less than that in the PC group (p< 0.05).
In the early stage of severe ARDS induced by oleic acid, compared with PC, retention of the BIPAP mode of SB can reduce the risk of lung injury and improve respiratory function.