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血管紧张素II拮抗剂对猪复苏后阶段器官灌注的影响。

Effects of an angiotensin II antagonist on organ perfusion during the post-resuscitation phase in pigs.

作者信息

Strohmenger HU, Lindner KH, Wienen W, Radermacher P

机构信息

Department of Anesthesiology and Critical Care Medicine, University of Ulm, Ulm, Germany.

出版信息

Crit Care. 1998;2(2):49-55. doi: 10.1186/cc125.

Abstract

BACKGROUND

The aim of this study was to compare pre-arrest and post-resuscitation organ perfusion values and to investigate whether, during the post-resuscitation phase, administration of the angiotensin II antagonist telmisartan (TELM) 10 min after restoration of spontaneous circulation (ROSC) could improve organ flow in comparison to placebo. RESULTS: Five minutes after ROSC in the TELM group, blood flow in the cortex and myocardium increased to 583% (P < 0.05) and 137% (not significant), respectively, whereas blood flow of the colon, stomach and pancreas decreased to 50% (P < 0.05), 28% (P < 0.05) and 19% (P < 0.05) of pre-arrest values, respectively. At 90 min after ROSC, pre-arrest perfusion values both in non-splanchnic and splanchnic organs were achieved. At no point in time were there significant differences between the two groups with respect to organ blood flow or speed of recovery of organ perfusion. CONCLUSIONS: During the post-resuscitation phase, organ blood flow is characterized by the coincidence of increased cerebral and myocardial blood flow and decreased intestinal blood flow. Administration of TELM 10 min after ROSC did not improve the recovery of organ perfusion.

摘要

背景

本研究旨在比较心脏骤停前和复苏后器官灌注值,并调查在复苏后阶段,与安慰剂相比,在自主循环恢复(ROSC)后10分钟给予血管紧张素II拮抗剂替米沙坦(TELM)是否能改善器官血流。结果:在TELM组ROSC后5分钟,皮质和心肌血流分别增加至583%(P < 0.05)和137%(无显著性差异),而结肠、胃和胰腺的血流分别降至心脏骤停前值的50%(P < 0.05)、28%(P < 0.05)和19%(P < 0.05)。在ROSC后90分钟,非内脏和内脏器官均达到心脏骤停前灌注值。在任何时间点,两组在器官血流或器官灌注恢复速度方面均无显著差异。结论:在复苏后阶段,器官血流的特征是脑血流和心肌血流增加而肠血流减少。ROSC后10分钟给予TELM并不能改善器官灌注的恢复。

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本文引用的文献

1
Estimation of hepatic blood flow with indocyanine green.用吲哚菁绿评估肝血流量。
J Clin Invest. 1962 May;41(5):1169-79. doi: 10.1172/JCI104570.
4
Vasoactive mediators and splanchnic perfusion.血管活性介质与内脏灌注
Crit Care Med. 1993 Feb;21(2 Suppl):S55-68. doi: 10.1097/00003246-199302001-00011.
9
10
Relation between intestinal blood flow and oxygen uptake.
Am J Physiol. 1982 Mar;242(3):G202-8. doi: 10.1152/ajpgi.1982.242.3.G202.

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