Résumé
Objective. To examine changes in respiratory dynamics in patients with chronic obstructive pulmonary disease (COPD) sitting leaning forward with hands supported on the knees (tripod position), a posture frequently assumed by patients in respiratory distress. Methods. Spirometry, maximal inspiratory and expiratory pressures (MIP and MEP) generated at the mouth, and diaphragmatic excursion during tidal and vital capacity maneuver breathing measured by B-mode ultrasonography were studied in 13 patients with stable COPD in sitting, supine and tripod positions. Results. Mean±SD age of patients was 52.2±6.8 years. Median disease duration was three years. There was no statistically significant difference in spirometry for sitting, supine and tripod positions (FEV1: 1.11±0.4L, 1.14±0.5L and 1.11±0.4L; p=0.99), respectively, (FEV1/FVC: 49.2±11.0, 53.7±8.5 and 48.5±11.3, p=0.37), mouth pressures (MIP: 102.9±28.9, 90.6±29.1 and 99.2±32.9 cm H2O, p=0.61 and MEP: 100.8±29.9, 100.4±34.4 and 90.6±32.6 cmH2O, p=0.74) and diaphragmatic movements during tidal (16.1±5.9, 20.1±6.8 and 16.6±6.2 mm, p=0.22) and forced breathing (33.9±11.0, 43.1±19.6 and 37.4±17.1 mm, p=0.35). Conclusion. Commonly measured indices of respiratory function were not different in the tripod compared to sitting and supine positions.
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AdulteRésumé
Objective To investigate the effects of Panax notoginseng saponins(PNS,三七总皂苷) on extra-vascular lung water(EVLW) and respiratory dynamics in dog with oleic acid induced acute lung injury(ALI).Methods Eighteen Beagle dogs,intubated and mechanically ventilated with intermittent positive pressure ventilation(IPPV) mode(tidal volume(VT) 10 ml/kg, positive end-expiratory pressure(PEEP) 0,inspiratory oxygen concentration(FiO2) 1.00),were randomly assigned into three groups(each n=6): normal control group,ALI model group(induced by intravenous injection of oleic acid) and PNS group(received PNS after the ALI model was constructed).PNS 10 mg/kg being dissolved in 100 ml 5% glucose solution(GS) was pumped into central vein (2.5 ml/min) after ALI model was formed in the PNS group.Similar amount of glucose solution was given to the normal control and model groups.Respiratory dynamics and arterial blood gas(ABG) were monitored every hour.Four hours after the establishment of ALI,the dogs were sacrificed and extra-vascular lung water index(EVLWI) was quantified by a gravimetric measurement.Results In ALI dogs,PNS significantly decreased the index of EVLWI((14.10?1.45) ml/kg vs.(17.97?0.85) ml/kg,P0.05).Conclusion PNS has certain protective effect on dog with oleic acid induced ALI,it may lower EVLW and elevate the Cst total,that is beneficial to the improvement of hypoxemia.