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find Keyword "呼吸机相关性肺损伤" 2 results
  • Protective Effect of Exogenous Pulmonary Surfactant on Ventilation-induced Lung Injury in Rats

    Objective To observe the effects of exogenous pulmonary surfactant (PS) on ventilation-induced lung injury (VILI) in rats, and to investigate its possible mechanisms. Methods A total of 40 Wistar rats were divided into 4 groups with randomized blocks method: control group, high tidal volume (HV) group, VILI group, and PS group, with 10 rats in each group. The control group was subjected to identical surgical procedure but was never ventilated. After 30 min of mechanical ventilation (MV) with Vt 45 ml/kg, the rats in HV group were killed immediately; rats in the VILI group were continually ventilated for up to 150 min with Vt 16 ml/kg; in the PS group, 100 mg/kg of PS administered intratracheally and with the same settings as VILI group. Mean artery pressure (MAP), blood gas analysis, lung wet to dry weight ratios (W/D), thorax-lung compliance, and cell counts in bronchoalveolar lavage fluid (BALF) were determined. Nuclear factor-κB(NF-κB) activity in lungs was measured by enzyme-linked immunosorbent assay (ELISA), interleukin-8(IL-8) in serum and BALF was determined by radioimmunoassay (RIA). Pathological examination of the lung was performed. Results Injurious ventilation significantly decreased MAP and PaO2/FiO2, but increased NF-κB activity and W/D. MAP and PaO2/FiO2 improved, but NF-κB activity, IL-8 in serum and BALF, and cell counts in BALF reduced significantly in PS group compared with those in VILI group. Histological studies showed reduced pulmonary edema and atelectasis in the PS group. Conclusion PS administered intratracheally can suppress the increased activity of NF-κB induced by VILI, exogenous PS can be used to treat VILI.

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 允许性高碳酸血症在预防呼吸机相关性肺损伤中的作用

    机械通气(mechanical ventilation,MV)作为全身麻醉和生命支持的必要手段,在手术和危重患者的呼吸治疗中占有重要地位;然而,使用不当可能给患者带来潜在的损害,可诱发或加重肺部病变,如呼吸机相关性肺损伤(ventilator-induced lung injury,VILI),保护性肺通气是一种新的MV模式,能在一定程度上减轻肺损伤的程度。既往已有研究发现高碳酸血症的治疗性生理效应,且近年提出在保护性通气模式下允许一定程度的高碳酸血症,即允许性高碳酸血症(permissive hypercapnia,PHC),有望改善患者的转归。目前,PHC 在围术期及重症患者的 MV 治疗中逐渐增加,其有效性已被证实,但保护机制、适应证及禁忌证仍不完全明确,二氧化碳的允许范围、安全界限等方面仍缺乏共识。该文将近年来关于机械通气导致 VILI 的相关机制和 PHC 的研究结果作一综述。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
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