Gleed F D, Ducharme N G, Hackett R P, Hakim T S, Erb H N, Mitchell L M, Soderholm L V
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA.
Equine Vet J Suppl. 1999 Jul(30):102-6. doi: 10.1111/j.2042-3306.1999.tb05198.x.
We hypothesised that frusemide would decrease pulmonary capillary pressure in horses during strenuous exercise. Seven horses were tested after receiving saline or frusemide (2 mg/kg bwt) in random order with an interval of at least one week. Measurements were made with the horses standing, exercising at 75, 90 and 100% HRmax (maximal heart rate), and then walking 2 min after cessation of 100% HRmax. The exercise tests lasted for approximately 3 min with an interval of walking between them. Pulmonary artery and oesophageal pressures were recorded continuously and subsequent analysis of the pulmonary artery pressure signal was carried out after subtraction of the oesophageal pressure signal. Pulmonary arterial pressure, pulmonary capillary pressure, pulmonary artery wedge pressure, breathing rate, heart rate and arterial blood gas tensions were recorded at each level of exercise. Pulmonary arterial wedge and pulmonary capillary pressures were determined from the pulmonary arterial waveform after dynamic occlusion of a branch of the pulmonary artery. The resulting decay in pressure was submitted to exponential curve fitting and the amplitude on this curve at the moment of occlusion was recorded as pulmonary capillary pressure. When adjusted for horse and exercise intensity, horses receiving frusemide had lower pulmonary capillary and wedge pressures (adjusted least-squares means = 36 mmHg and 28 mmHg, respectively) when compared with control values (adjusted least-squares means = 41 mmHg (P = 0.042) and 35 mmHg (P = 0.002), respectively). Pulmonary arterial pressure, breathing rate, heart rate and arterial blood gas tensions did not differ between treatments at any exercise intensity. We conclude that frusemide reduces pulmonary capillary and wedge pressures. This is compatible with reduced transcapillary filtration and, therefore, reduced accumulation of lung water at exercise. It may also account for the putative protective effect of frusemide against exercise-induced pulmonary haemorrhage.
我们假设,速尿可降低马匹剧烈运动时的肺毛细血管压力。七匹马按随机顺序接受生理盐水或速尿(2毫克/千克体重)注射,间隔至少一周后进行测试。测量时马匹分别处于站立状态、以75%、90%和100%最大心率(HRmax)进行运动,然后在100% HRmax运动停止后步行2分钟。运动测试持续约3分钟,每次测试之间有步行间隔。持续记录肺动脉和食管压力,在减去食管压力信号后对肺动脉压力信号进行后续分析。在每个运动水平记录肺动脉压、肺毛细血管压、肺动脉楔压、呼吸频率、心率和动脉血气张力。通过动态阻断肺动脉分支后根据肺动脉波形确定肺动脉楔压和肺毛细血管压。将压力衰减结果进行指数曲线拟合,并将阻断瞬间该曲线上的振幅记录为肺毛细血管压。在根据马匹和运动强度进行调整后,接受速尿的马匹与对照值相比,肺毛细血管压和楔压较低(调整后的最小二乘均值分别为36毫米汞柱和28毫米汞柱),对照值分别为41毫米汞柱(P = 0.042)和35毫米汞柱(P = 0.002)。在任何运动强度下,各治疗组之间的肺动脉压、呼吸频率、心率和动脉血气张力均无差异。我们得出结论,速尿可降低肺毛细血管压和楔压。这与跨毛细血管滤过减少相符,因此在运动时肺水蓄积减少。这也可能解释了速尿对运动性肺出血的假定保护作用。