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麻醉犬急性血容量扩张后血浆抗利尿激素浓度的容量控制

Volume control of plasma antidiuretic hormone concentration following acute blood volume expansion in the anesthetized dog.

作者信息

Shade R E, Share L

出版信息

Endocrinology. 1975 Oct;97(4):1048-57. doi: 10.1210/endo-97-4-1048.

Abstract

Acute volume expansion was produced in 9 dogs by infusing a lactated Ringer's solution at 1 ml/kg/min in a volume estimated to increase blood volume by 20%. Volume expansion was maintained by replacing urinary fluid losses with equal volumes of the Ringer's solution. Following volume expansion, the effects of a slow, nonhypotensive hemorrhage on plasma antidiuretic hormone concentration (PADH) were determined and compared to a group of 9 normovolemic dogs subjected to the same hemorrhage procedure, in order to determine if volume receptor control of ADH release would adapt to acute increases in blood volume. Ringer's infusion significantly increased blood volume to 95.2 +/- 3.1 ml/kg (mean +/- SE; P less than 0.01) when compared to a mean normovolemic blood volume of 77.6 +/- 3.4 ml/kg. Volume expansion was associated with a significantly lower PADH (3.2 +/- 1.6 muU/ml) than that in normovolemic dogs (5.7 +/- 1.2 muU/ml; p less than 0.05). Significant increases in PADH (P less than 0.05) occurred in both groups of dogs after 20 and 40 minutes of a continuous, nonhypotensive hemorrhage (0.40 to 0.45 mg/kg/min. Hemmorrhage was also associated with significant decrease in effective left atrial pressure in both groups of dogs after 5, 10, 20, and 40 minutes of hemorrhage (P less than 0.01). There were no significant differences between the two groups of dogs nor were there any significant changes during the experiment within each group for mean arterial blood pressure, arterial pulse pressure, plasma osmolality, plasma sodium concentration and plasma potassium concentration. Effective left atrial pressure and PADH were found to be exponentially correlated with blood volume in bothy hypervolemic and normovolemic dogs. Analysis of covariance of these correlations suggested that the hypervolemic dogs exhibited the same exponential changes in PADH and effective left atrial pressure with decreased blood volume as in the normovolemic dogs. It is concluded that acute volume expansion does not alter volume control of plasma ADH concentration.

摘要

对9只犬进行急性容量扩张,以1 ml/kg/min的速度输注乳酸林格氏液,输注量估计可使血容量增加20%。通过用等量的林格氏液补充尿液丢失来维持容量扩张。容量扩张后,测定缓慢、非低血压性出血对血浆抗利尿激素浓度(PADH)的影响,并与9只血容量正常的犬进行相同出血程序后的情况进行比较,以确定ADH释放的容量受体控制是否会适应血容量的急性增加。与平均血容量正常的77.6±3.4 ml/kg相比,林格氏液输注显著增加血容量至95.2±3.1 ml/kg(平均值±标准误;P<0.01)。容量扩张与显著低于血容量正常犬的PADH(3.2±1.6 μU/ml)相关(血容量正常犬为5.7±1.2 μU/ml;P<0.05)。在持续非低血压性出血(0.40至0.45 mg/kg/min)20分钟和40分钟后,两组犬的PADH均显著增加(P<0.05)。出血5、10、20和40分钟后,两组犬的有效左心房压力也均显著降低(P<0.01)。两组犬之间无显著差异,且每组实验期间平均动脉血压、动脉脉压、血浆渗透压、血浆钠浓度和血浆钾浓度均无显著变化。发现血容量过多和血容量正常的犬中,有效左心房压力和PADH与血容量呈指数相关。对这些相关性的协方差分析表明,血容量过多的犬与血容量正常的犬一样,随着血容量降低,PADH和有效左心房压力呈现相同的指数变化。得出结论,急性容量扩张不会改变血浆ADH浓度的容量控制。

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