代謝性アシドーシス時の肺ガス交換 ―第3報 混合静脈血酸素分圧の変化が動脈血酸素分圧に及ぼす影響―
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In the previous study, when the dogs were ventilated with air, we reported that the paradoxical increase of Pa o2 during severe metabolic acidosis occured mainly by the increase of alveolar oxygen tension owing to change in the respiratory quotient and it might be related to the increase of Pv o2 owing to a shift to the right of the oxygen dissociation curve. Meanwhile, it is generally accepted that a change in the respiratory quotient will not affect the alveolar oxygen tension during oxygen ventilaton. Basic research on the effect of Pv o2 to Pa o2 is has rarely been reported. So in the present study, the effect of Pv o2 to Pa o2 was assessed and compared with the computer simulation reported in the previous study. Then the possibility of the paradoxical increase of Pa o2 during severe metabolic acidosis was examined, when the dogs were ventilated with oxygen. The femoral arteriovenous shunts were prepared in ten dogs to make a higher value for Pv o2. The respiratory and circulatory indexes were measured in four conditions which consisted of combinations of the ventilated gas, air or oxygen, and the femoral shunt, was either closed or opened. And then the same indexes were measured prior to and after hydrochloride load, 0.3 N HCl infusion at a speed of 1 ml/kg/min, when the dogs were ventilated with oxygen and the femoral arteriovenous shunt was closed. The following results were obtained. A: Whenever the dogs were ventilated with air or oxygen, Pv o2 and Pa o2 increased significantly after opening of the femoral arteriovenous shunt but the pulmonary shunt rate did not change. B: The change in Pa o2 owing to the increase of Pv o2 was almost similar to the computer simulation reported in the previous study. C: When the dogs were ventilated with oxygen, the pulmonary shunt rate became smaller than when air was used. D: Though mean pulmonary arterial pressure increased significantly, Pv o2 and Pa o2 increased ?significantly after the hydrochloride load during oxygen ventilation. A-a Do2 decreased significantly, too, but the pulmonary shunt rate did not change. In conclusion, the increase of Pv o2 made Pa o2 higher without any pulmonary function improvement. The paradoxical increase of Pa o2 could appear during severe metabolic acidosis even in oxygen ventilation. In order to evaluate pulmonary gas exchange efficiency, it is important to measure the value of Pv o2.
- 札幌医科大学の論文
- 1987-02-02
札幌医科大学 | 論文
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