低温气体机械通气对犬体温和呼吸的影响
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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、常温组。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,两组呼吸参数均设为:VT=15ml/kg;RR=15bpm;I:E=1:2。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。0min至240 min每30min共九个时间点分别观察并记录实验犬鼻咽温、腋温、血温。取0min、30min、1h、2h、3h、4h共五个时间点分别观察并记录实验犬动脉血气数据(PaO2、PaCO2、PH)和呼吸力学数据(Raw、PIP、Cstat)。0min、2h、4h共三个时间点分别抽血用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);在机械通气后30min低温组的PaO2值显著低于常温组(367.02±17.10vs388.69±10.99mmHg)(P<0.05);低温组和常温组的PO2除30min时点有差别外,其它时间点上两组PO2均无差别(P>0.05);低温组和常温组各时间点的PaCO2、PH及各呼吸力学参数(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浓度分别为(0.29±0.02,0.28±0.02)ng·mL-1显著低于常温组相应时间点(0.31±0.33, 0.30±0.03)ng·mL-1;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为(2.44±1.03)显著低于常温组(4.01±1.31),差异有显著性(P=0.012)。
结论:低温气体机械通气对犬的的全身温度(体温)没有明显的影响;低温气体机械通气对犬血气交换和呼吸力学没有显著影响;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。
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); PaO2 in the hypothermia group at 30min was significantly lower than normothermia group(367.02±17.10[hypothermia]vs388.69±10.99[normothermia]mmHg)(P<0.01),There were no differences in PaO2 except that of 30min between the hypothermia group and the normothermia group (P>0.05); There were no statistical significances in 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(at 2hours; 0.29±0.02 [hypothermia] vs 0.31±0.33[normothermia]ng·mL-1;at 4hours 0.28±0.02 [hypothermia] ng·mL-1vs0.30±0.03[normothermia] ng·mL-1);Plasma TNF-αconcentrations at 2h points significantly increased in both groups compared with basal level.But there were no significant differences in Plasma TNF-αconcentrations between the two group.and Cumulative mean histology scores showed a lower score in hypothermia group(2.44±1.03) compared with normothermia group(4.01±1.31) (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.
方法:将健康雄性杂种犬18只,随机均分为2组,即低温组、常温组。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,两组呼吸参数均设为:VT=15ml/kg;RR=15bpm;I:E=1:2。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。0min至240 min每30min共九个时间点分别观察并记录实验犬鼻咽温、腋温、血温。取0min、30min、1h、2h、3h、4h共五个时间点分别观察并记录实验犬动脉血气数据(PaO2、PaCO2、PH)和呼吸力学数据(Raw、PIP、Cstat)。0min、2h、4h共三个时间点分别抽血用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);在机械通气后30min低温组的PaO2值显著低于常温组(367.02±17.10vs388.69±10.99mmHg)(P<0.05);低温组和常温组的PO2除30min时点有差别外,其它时间点上两组PO2均无差别(P>0.05);低温组和常温组各时间点的PaCO2、PH及各呼吸力学参数(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浓度分别为(0.29±0.02,0.28±0.02)ng·mL-1显著低于常温组相应时间点(0.31±0.33, 0.30±0.03)ng·mL-1;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为(2.44±1.03)显著低于常温组(4.01±1.31),差异有显著性(P=0.012)。
结论:低温气体机械通气对犬的的全身温度(体温)没有明显的影响;低温气体机械通气对犬血气交换和呼吸力学没有显著影响;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。
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); PaO2 in the hypothermia group at 30min was significantly lower than normothermia group(367.02±17.10[hypothermia]vs388.69±10.99[normothermia]mmHg)(P<0.01),There were no differences in PaO2 except that of 30min between the hypothermia group and the normothermia group (P>0.05); There were no statistical significances in 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(at 2hours; 0.29±0.02 [hypothermia] vs 0.31±0.33[normothermia]ng·mL-1;at 4hours 0.28±0.02 [hypothermia] ng·mL-1vs0.30±0.03[normothermia] ng·mL-1);Plasma TNF-αconcentrations at 2h points significantly increased in both groups compared with basal level.But there were no significant differences in Plasma TNF-αconcentrations between the two group.and Cumulative mean histology scores showed a lower score in hypothermia group(2.44±1.03) compared with normothermia group(4.01±1.31) (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.
引文
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