Reber A, Budmiger B, Wenk M, Haefeli W E, Wolff T, Bein T, Skarvan K
Department of Anaesthesia, University of Basel/Kantonsspital, Switzerland.
Br J Anaesth. 2000 May;84(5):565-70. doi: 10.1093/bja/84.5.565.
Twenty consecutive patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were allocated at random to group 1 (n = 10, high inspired oxygen fraction (FIO2) after CPB), or group 2 (n = 10, moderate FIO2 after CPB). The effects of each FIO2 on arterial and mixed venous concentrations of endothelin-1 (ET-1) and its precursor, Big ET-1, were measured. Venous admixture was calculated to assess the efficiency of pulmonary gas exchange. Patients whose lungs had been ventilated with a FIO2 of 1.0 (exposure time 70 min) after weaning from the CPB machine had significantly greater arterial and mixed venous Big ET-1 concentrations and venous admixture than patients whose lungs were ventilated with a FIO2 of 0.35. In contrast, ET-1 concentrations in the two groups were not significantly different. A reduction of FIO2 from 1.0 to 0.6 reduced venous admixture without lowering endothelial peptide concentrations. On the first postoperative day all peptide concentrations were similar in the two groups, whereas venous admixture remained non-significantly higher in group 1. A short period of high FIO2 immediately after CPB increases endothelin concentrations and pulmonary venous admixture.
连续20例接受体外循环心脏手术的患者被随机分为1组（n = 10，体外循环后高吸入氧分数（FIO2））或2组（n = 10，体外循环后中等FIO2）。测量了每种FIO2对内皮素-1（ET-1）及其前体大内皮素-1（Big ET-1）的动脉血和混合静脉血浓度的影响。计算静脉混合以评估肺气体交换效率。与在脱离体外循环机后用FIO2为0.35进行肺通气的患者相比，用FIO2为1.0（暴露时间70分钟）进行肺通气的患者的动脉血和混合静脉血中的大内皮素-1浓度及静脉混合显著更高。相比之下，两组中的内皮素-1浓度无显著差异。将FIO2从1.0降至0.6可降低静脉混合而不降低内皮肽浓度。术后第一天两组中所有肽浓度相似，而1组中的静脉混合仍略高但无统计学意义。体外循环后立即短时间给予高FIO2会增加内皮素浓度和肺静脉混合。
