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目的 建立死腔内气体吸出技术 (ASPIDS)的方法 ,并探讨ASPIDS对急性高碳酸血症(HC)杂种犬二氧化碳清除的效果及其对通气效率的改善作用。方法 将 12只杂种犬分为常规机械通气 (CMV)组和高碳酸血症 (HC)组 ,每组 6只。用自行设计的ASPIDS装置对两组动物行气管内吹气(TGI)和ASPIDS ,分别观察两组动物在TGI(吹气流量 4 0L min)和ASPIDS(抽气流量 4 0L min)时呼气末二氧化碳分压 (PetCO2 )、血气、呼吸力学、血流动力学等指标的变化。结果 (1)ASPIDS可明显降低两组动物的动脉血二氧化碳分压 (PaCO2 )水平 (P <0 0 0 0 1) ,并能在潮气量 (VT)降低 30 %的情况下维持PaCO2 在正常范围 ,ASPIDS对二氧化碳的清除效果优于TGI;(2 )ASPIDS使两组动物的气道压力明显降低 (P <0 0 0 0 1) ;(3)ASPIDS使PetCO2 和呼气阻力 (Re)显著降低 ,而对肺顺应性 (Cst)无明显影响(P >0 0 5 ) ;(4 )ASPIDS对血流动力学和氧动力学指标无显著影响 (P >0 0 5 )。结论 ASPIDS是一种简便实用的机械通气的辅助手段 ,较TGI更能有效地降低PaCO2 ,并使气道压力维持在较低的水平
Objective To establish a method of dead space gas aspiration (ASPIDS) and investigate the effect of ASPIDS on carbon dioxide (CO2) clearance in acute hypercapnic (HC) hybrid dogs and its effect on ventilation efficiency. Methods 12 hybrid dogs were divided into conventional mechanical ventilation (CMV) group and hypercapnia (HC) group, 6 rats in each group. Two groups of animals were intratracheally inflated (TGI) and ASPIDS with a self-designed ASPIDS device. Two groups of animals were observed at the end of expiration at TGI (inflow of 40L) and ASPIDS (extraction of 40L) Carbon dioxide partial pressure (PetCO2), blood gas, respiration mechanics, hemodynamics and other indicators of change. Results (1) ASPIDS significantly reduced the PaCO2 level (P <0.01) in both groups and maintained PaCO2 in the normal range when tidal volume (VT) decreased by 30% (2) ASPIDS significantly reduced airway pressure in both groups (P <0.01); (3) ASPIDS significantly decreased PetCO2 and expiratory resistance (Re) (P> 0.05). (4) ASPIDS had no significant effect on hemodynamics and oxygenation index (P> 0.05). Conclusion ASPIDS is a convenient and practical auxiliary method of mechanical ventilation, which can reduce PaCO2 more effectively than TGI and maintain airway pressure at a relatively low level