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폐세척으로 유발된 호흡부전에서의 고빈도 Jet 환기법의 효과
이관호(Kwan Ho Lee),박시화(Si Hwa Park),노진우(Jin Woo Rho),김태년(Tae Nyeun Kim),정진홍(Jin Hong Chung),이현우(Hyun Woo Lee),이석강(Suck Kang Lee) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Background: To identify the efficiency on gas exchange and pulmonary pathologic changes of high frequency jet ventilation (HFJV) compared with conventional mechanical ventilation (CMV) in saline-lavaged rabbits. Methods: Twenty New Zealand white rabbits (2.7-3.1 kg) were studied under intravenous anesthesia. Following tracheostomy, a surfactant-depletion lung- injury model was produced by normal saline lavage. During the next 2 hours, rabbits were ventilated with CMV or HFJV. Arterial blood gas was measured every 30 minutes. After completion of 2 hours ventilation, the animals were sacrified and the lungs were fixed for microscopy and the degree of hyaline membrane formation was compared in each ventilation. Results: Arterial oxygenation was more efficient with HFJU (395±124mmHg, 379±127mmHg, 412±115mmHg and 421±119mmHg, at 30 minutes, 60 minutes, 90 minutes and 120 minutes) than with CMV (79±38mmHg, 81±48mmHg, 107±103mmHg and 119±123mmHg; p < 0.001), A sustained inflation resulted in immediate and sustained increase in PaO2 with HFJV (from 81±25mmHg to 357±109mmHg), but no significant increases with CMU (from 80±22mmHg to 100±68mmHg). Arterial oxygenation was more efficient with HF3V (395±124, 379±127, 412±115 and 421±119mmHg, at 30, 60, 90 and 120 minutes) than with CMV (79±38, 81±48, 107±103, 119±123mmHg; p<0.0001). Hyaline membranes were slightly more developed with CMU, but not significant compared with HFJV. Death resulted from pneumothorax or a progressive metabolic acidosis with CMV, but all the rabbits with HFJV survived until the planned termination of the protocol. Conclusions: HFJV produced more efficient gas exchange, when combined with a sustained inflation in surfactant-depletion lung-injury model by saline lavage, however, did not improve pulmonary pathology.