tailieunhanh - Báo cáo y học: "The influence of venous admixture on alveolar dead space and carbon dioxide exchange in acute respiratory distress syndrome: computer modelling"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: The influence of venous admixture on alveolar dead space and carbon dioxide exchange in acute respiratory distress syndrome: computer modelling. | Available online http content 1 2 2 R53 Research The influence of venous admixture on alveolar dead space and carbon dioxide exchange in acute respiratory distress syndrome computer modelling Lisbet Niklason Johannes Eckerstrom and Bjorn Jonson Department of Clinical Physiology University Hospital Getingevagen 4 SE-221 85 Lund Sweden Corresponding author Lisbet Niklason Received 4 Oct 2007 Revisions requested 7 Nov 2007 Revisions received 28 Feb 2008 Accepted 18 Apr 2008 Published 18 Apr 2008 Critical Care 2008 12 R53 doi cc6872 This article is online at http content 12 2 R53 2008 Santos et al. licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Open Access Abstract Introduction Alveolar dead space reflects phenomena that render arterial partial pressure of carbon dioxide higher than that of mixed alveolar gas disturbing carbon dioxide exchange. Right-to-left shunt fraction Qs Qt leads to an alveolar dead space fraction VdAS VtA where VtA is alveolar tidal volume . In acute respiratory distress syndrome ancillary physiological disturbances may include low cardiac output high metabolic rate anaemia and acid-base instability. The purpose of the present study was to analyze the extent to which shunt contributes to alveolar dead space and perturbs carbon dioxide exchange in ancillary physiological disturbances. Methods A comprehensive model of pulmonary gas exchange was based upon known equations and iterative mathematics. Results The alveolar dead space fraction caused by shunt increased nonlinearly with Qs Qt and under basal conditions reached at a Qs Qt of . At a Qs Qt of reduction in cardiac output from 5 l minute to 3 l minute increased VdAS VtA from to

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