a widening of the distribution

Effect of Age on V˙/Q˙ Ratios During Anaesthesia

In awake subjects, increasing age causes a widening of the distribution of V˙/Q˙  ratios, and the distribution widens still further with anaesthesia.1It would thus be expected that intrapulmonary shunt during anaesthesia would also increase with age, but studies of this effect have produced variable results, probably because of differences in measurement techniques and degrees of lung pathology in older patients. The most thorough study, which only included 45 patients, ranging in age from 23 to 69 years, concluded that atelectasis (as seen with CT) and true intrapulmonary shunt (determined by multiple inert gas elimination technique as alveoli with V˙/Q˙  ,0.005) did not relate to age.1However, both were substantially increased during anaesthesia and correlated with each other, and this study confirmed the enhanced decline in arterial Po2 with increasing age during anaesthesia. Venous admixture (calculated as for the three-compartment model) was increased significantly from a mean value of 5.5% of cardiac output before anaesthesia to 9.2% during anaesthesia. Venous admixture increased steeply with age (0.17% per year), and this was attributed to an age-dependent increase in the spread of V˙/Q˙  ratios (Fig. 21.19) and to greater perfusion of alveoli with low V˙/Q˙  ratios (0.005–0.1).

年龄对麻醉期间/比值的影响

清醒患者中，增龄导致/比失调增加，麻醉后进一步增大19。因此，可以预期随年龄增长，麻醉时的肺内分流也会而增加。但可能因测量技术及老年患者肺部病理程度的差异，麻醉对分流影响的研究结果并不一致。最深入的研究仅包括45例患者（23～69岁），结论是肺不张（如CT所见）和真性肺内分流（通过多种惰性气体消除技术确定，以肺泡的/＜0.005为确定标准）与年龄无关。可在麻醉时，该研究证实肺不张和肺内真性分流均显著增加，并相互关联，随增龄PaO2下降增强。按三室模型计算，静脉血掺杂从麻醉前心输出量平均值的5.5%显著增加至麻醉期间的9.2%。这是因为随增龄，/比失调增加（图21.19），加之低/比（0.005-0.1）的肺泡灌注增多，因此静脉血掺杂随增龄而急剧增加（0.17%/年）。

各位老师，a widening of the distribution of V˙/Q˙  ratios 和 increase in the spread of V˙/Q˙  ratios

能直接翻译成“V˙/Q˙失调”吗？谢谢