Summary
The surface activity of tracheal-bronchial secretions of 37 patients with and without chronic pulmonary disease were measured before and during inhalation anaesthesia. Patients with pulmonary disease (PD) had significantly higher mean minimal surface tensions of secretions (γ mins) before anaesthesia than those without disease (PN). Halothane, a fat soluble anaesthetic, significantly elevated secretion γ mins in PN patients but did not affect those with PD. Nitrous oxide, a gas not soluble in fat, did not change secretion γ mins in PN patients but significantly decreased these values in those with PD. These findings suggest that positive pressure ventilation can increase surfactant activity in patients with pulmonary disease but concomitant use of a fat soluble inhalation anaesthetic may overcome the benefits of such therapy.
Résumé
Les malades porteurs de maladies pulmonaires (M.P.) présentent, dans les sécrétions de leurs voies respiratoires hautes, une tension de surface moyenne minimale (γ mins) plus élévée que les malades normaux (M.N.) Une substance anesthésique soluble dans les graisses tel l'halothane élève de façon significative la γ mins chez les M N mais ne change rien chez les MP. Le protoxyde d'azote, un gaz insoluble dans les graisses, diminue de façon significative la γ mins des sécrétions chez les porteurs MP et n'affecte pas la γ mins des sécrétions des MN. Ces découvertes permettent de croire que la ventilation avec pression positive peut accroître l'activité du surfactant chez les porteurs de maladies pulmonaires mais que l'usage concomittant d'un agent anesthésique par inhalation et soluble dans les graisses peut entraver les effets bénéfiques de cette thérapie.
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Stanley, T.H., Zikria, B.A. The effects of general anaesthesia on the surface tension of secretions in the upper airway in patients with and without pulmonary disease. Canad. Anaesth. Soc. J. 20, 290–295 (1973). https://doi.org/10.1007/BF03027167
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DOI: https://doi.org/10.1007/BF03027167