国际麻醉学与复苏杂志   2011, Issue (6): 15-15
    
低温气体机械通气对犬体温和呼吸的实验研究
魏 福 生, 马龙先, 杨蕾, 钟钦文1()
1.南昌大学第一附属医院
Effect of Mechanical Ventilation with Cold air on Body Temperature And Respiratory in Dogs
 全文:
摘要：

【摘要】目的：观察低温气体机械通气对犬体温、呼吸力学、血气参数值及肺组织病理学的影响，探索一种新的降体温方法及该方法对呼吸的影响。方法：将健康雄性杂种犬18只，随机均分为2组，即低温组(HG)、常温组(NG)。气管插管后行机械通气，低温组和常温组分别通4℃低温气体和25℃常温气体，犬气管插管后立即开始计时（即0min并作为基础值）连续观察240min。每30min分别观察并记录实验犬鼻咽温、腋温、血温；取机械通气0min、1h、2h、3h、4h五个时间点分别观察并记录实验犬动脉血气（PaO2、PaCO2、PH）和呼吸力学参数（Raw、PIP、Cstat）。机械通气0min、2h、4h三个时间点用ELISA法测IL-6、TNF-α浓度，最后取肺组织在光镜下观察其病理学变化。结果：低温组和常温组不同通气时间的体温（鼻咽温、腋温、血温）差别无显著性（P＞0.05），低温组和常温组各时间点的PaO2、PaCO2、PH及Raw、Ppeak、Cstat均无明显差异（P>0.05）。在2h、4h时间点的低温组和常温组IL-6水平显著高于基础值（P<0.05），在通气2h、4h时间点的低温组IL-6浓度显著低于常温组相应时间点浓度；在2h时间点低温组和常温组TNF-α浓度显著高于基础值（P<0.05），但在各时间点两组TNF-α浓度无明显差异（P>0.05）；低温组肺组织累积平均评分显著低于常温组。 结论：低温气体机械通气对犬的的体温没有明显的影响，低温气体机械通气对犬血气交换、呼吸力学没有明显的影响；与常温气体机械通气相比4℃低温气体机械通气能抑制炎性因子（IL-6）的分泌，减轻肺组织病理损伤。
关键词： 关键词：低温气体；机械通气；犬；体温；呼吸
Abstract:

Objective: To investigate the effect of mechanical ventilation with cold air on body temperature, pneodynamics , blood gas parameters and histological changes of lung tissues in dogs.To search for a new method to lower body temperature and its effect on respiratory. Methods:Eighteen healthy male dogs were randomly divided into two groups, hypothermia group(n=9) and normothermia group(n=9).The animals were ventilated with cold air(4℃) and normal air(25℃) respectively,ventilation parameters were set as (VT=15ml/kg,RR=15bpm,I:E=1:2) in each group. The body temperatures(Tnp, Tb,Ta) were recorded immediately and repeatedly every 30mins until 240min post-intubation. Blood gas parameters(PaO2,PaCO2,PH) and pneodynamic parameters (Raw,Ppeak,Cstat)were measured at 0min,30min,1hour,2hours,3hours and 4hours after intubation. Plasma cytokine(TNF-αlpha,IL-6)concentrations at 0min, 2hours and 4hours were determined by ELISA,And histopathologic appearance of lung tissue was analyzed by light microscopy. Results: There were no significant differences in all values of body temperatures between the two groups(P＞0.05); There were no statistical significances in PaO2,PaCO2 , PH, Raw,Ppeak,Cstat values at different time between the hypothermia group and the normothermia group.In addition, Plasma IL-6 concentrations at 2h and 4h increased significantly in both groups compared with basal level. However, serum IL-6 at 2h and 4h significantly lower in hypothermia compared with normothermia group;Plasma TNF-α concentrations at 2h points significantly increased in both groups compared with basal level.But there were no significant differences in Plasma TNF-α concentrations between the two group.and Cumulative mean histology scores showed a lower score in hypothermia group compared with normothermia group (P<0.05). Conclusion: These results indicate that cold air ventilation has no effect on body temperature.And cold air ventilation has no influences on pneodynamics and gas exchange.Furthermore ,cold air(4℃) ventilation has beneficial effect on attenuated the elevation of serum IL-6 concentrations and attenuate injury in lung tissues compared with normal air mechanical ventilation.
Key words: Key words: Cold air ;Mechanical Ventilation ;Body Temperature ;Canine; Respiratory;