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新型超短效β-肾上腺素能阻滞剂ONO-1101在体外循环期间及之后对心脏功能的影响。

The effects of a new ultra-short-acting beta-adrenergic blocker, ONO-1101, on cardiac function during and after cardiopulmonary bypass.

作者信息

Ahmet I, Fukushima N, Sawa Y, Masai T, Kadoba K, Kagisaki K, Chang J C, Yamaguchi T, Matsuda H

机构信息

First Department of Surgery, Osaka University Medical School, Suita, Japan.

出版信息

Surg Today. 1999;29(3):248-54. doi: 10.1007/BF02483015.

Abstract

The administration of an ultra-short-acting beta-adrenergic antagonist, esmolol, has been introduced as a novel method for beating-heart surgery. In the present study, a new ultra-short-acting beta-blocker, ONO-1101, was administered during cardiopulmonary bypass (CPB) to investigate its effects on cardiac function and hemodynamics. Nine adult mongrel dogs underwent 60 min of CPB during which they were given either ONO-1101 (ONO group; n = 4) or saline (control group; n = 5). In the ONO group, the hearts became flaccid enough for surgery to be performed without cardiac standstill within 10 min after the commencement of ONO-1101 with significant decreases in the heart rate, the preload recruitable stroke work (PRSW), and the slope of the end-systolic left ventricular pressure-volume relationship (Emax). The mean arterial pressure and systemic vascular resistance also decreased, but were maintained above 50 mmHg during CPB without catecholamine. These indices increased to the control group level 20 min after the discontinuation of ONO-1101. The serum concentration of ONO-1101 decreased from the maximum level of 121 +/- 15 microg/ml soon after infusion to 11 +/- 5 microg/ml within 30 min after discontinuation. These data suggest that ONO-1101 may be useful to enable beating-heart surgery to be performed without aortic cross-clamp as an ultra-short-acting beta-adrenergic blocker.

摘要

超短效β-肾上腺素能拮抗剂艾司洛尔的应用已被引入作为心脏不停跳手术的一种新方法。在本研究中,一种新型超短效β受体阻滞剂ONO-1101在体外循环(CPB)期间给药,以研究其对心脏功能和血流动力学的影响。9只成年杂种犬接受了60分钟的CPB,在此期间,它们被给予ONO-1101(ONO组;n = 4)或生理盐水(对照组;n = 5)。在ONO组中,在开始给予ONO-1101后10分钟内,心脏变得足够松弛,能够在不进行心脏停搏的情况下进行手术,心率、可募集的前负荷搏功(PRSW)和收缩末期左心室压力-容积关系斜率(Emax)显著降低。平均动脉压和全身血管阻力也降低,但在CPB期间不使用儿茶酚胺的情况下维持在50 mmHg以上。在停用ONO-1101后20分钟,这些指标升至对照组水平。ONO-1101的血清浓度从输注后不久的最高水平121±15μg/ml在停药后30分钟内降至11±5μg/ml。这些数据表明,ONO-1101作为一种超短效β-肾上腺素能阻滞剂,可能有助于在不进行主动脉交叉钳夹的情况下进行心脏不停跳手术。

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