Respiratory mechanics and gas exchange in an ovine model of congenital heart disease with increased pulmonary blood flow and pressure

在先天性心脏病绵羊模型中,肺血流量和肺压增加时,呼吸力学和气体交换的变化

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Abstract

In a model of congenital heart disease (CHD), we evaluated if chronically increased pulmonary blood flow and pressure were associated with altered respiratory mechanics and gas exchange. Respiratory mechanics and gas exchange were evaluated in 6 shunt, 7 SHAM, and 7 control age-matched lambs. Lambs were anesthetized and mechanically ventilated for 15 min with tidal volume of 10 mL/kg, positive end-expiratory pressure of 5 cmH(2)O, and inspired oxygen fraction of 0.21. Respiratory system, lung and chest wall compliances (C(rs), C(L) and C(cw), respectively) and resistances (R(rs), R(L) and R(cw), respectively), and the profile of the elastic pressure-volume curve (%E(2)) were evaluated. Arterial blood gases and volumetric capnography variables were collected. Comparisons between groups were performed by one-way ANOVA followed by Tukey-Kramer test for normally distributed data and with Kruskal-Wallis test followed by Steel-Dwass test for non-normally distributed data. Average C(rs) and C(L) in shunt lambs were 30% and 58% lower than in control, and 56% and 68% lower than in SHAM lambs, respectively. C(cw) was 52% and 47% higher and R(cw) was 53% and 40% lower in shunt lambs compared to controls and SHAMs, respectively. No difference in %E(2) was identified between groups. No difference in respiratory mechanics was observed between control and SHAM lambs. In shunt lambs, R(cw), C(rs) and C(L) were decreased and C(cw) was increased when compared to control and SHAM lambs. Pulmonary gas exchange did not seem to be impaired in shunt lambs when compared to controls and SHAMs.

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