Schenkman Kenneth A, Beard Daniel A, Ciesielski Wayne A, Feigl Eric O
Anesthesia and Critical Care 9-G1, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
Am J Physiol Heart Circ Physiol. 2003 Nov;285(5):H1819-25. doi: 10.1152/ajpheart.00383.2003. Epub 2003 Jul 17.
Myocardial mean myoglobin oxygen saturation was determined spectroscopically from isolated guinea pig hearts perfused with red blood cells during increasing hypoxia. These experiments were undertaken to compare intracellular myoglobin oxygen saturation in isolated hearts perfused with a modest concentration of red blood cells (5% hematocrit) with intracellular myoglobin saturation previously reported from traditional buffer-perfused hearts. Studies were performed at 37 degrees C with hearts paced at 240 beats/min and a constant perfusion pressure of 80 cmH2O. It was found that during perfusion with a hematocrit of 5%, baseline mean myoglobin saturation was 93% compared with 72% during buffer perfusion. Mean myoglobin saturation, ventricular function, and oxygen consumption remained fairly constant for arterial perfusate oxygen tensions above 100 mmHg and then decreased precipitously below 100 mmHg. In contrast, mean myoglobin saturation, ventricular function, and oxygen consumption began to decrease even at high oxygen tension with buffer perfusion. The present results demonstrate that perfusion with 5% red blood cells in the perfusate increases the baseline mean myoglobin saturation and better preserves cardiac function at low oxygen tension relative to buffer perfusion. These results suggest that caution should be used in extrapolating intracellular oxygen dynamics from buffer-perfused to blood-perfused hearts.
在逐渐增加缺氧程度的过程中,通过光谱法测定了用红细胞灌注的离体豚鼠心脏的心肌平均肌红蛋白氧饱和度。进行这些实验是为了比较用适度浓度的红细胞(血细胞比容为5%)灌注的离体心脏中的细胞内肌红蛋白氧饱和度与先前传统缓冲液灌注心脏所报道的细胞内肌红蛋白饱和度。实验在37摄氏度下进行,心脏以每分钟240次的频率起搏,灌注压力恒定为80厘米水柱。结果发现,在血细胞比容为5%的灌注过程中,基线平均肌红蛋白饱和度为93%,而在缓冲液灌注过程中为72%。对于动脉灌注液氧分压高于100毫米汞柱时,平均肌红蛋白饱和度、心室功能和氧消耗保持相当恒定,然后在低于100毫米汞柱时急剧下降。相比之下,在缓冲液灌注时,即使在高氧分压下,平均肌红蛋白饱和度、心室功能和氧消耗也开始下降。目前的结果表明,相对于缓冲液灌注,灌注液中5%的红细胞灌注可提高基线平均肌红蛋白饱和度,并在低氧分压下更好地保持心脏功能。这些结果表明,在将细胞内氧动力学从缓冲液灌注心脏外推到血液灌注心脏时应谨慎。