Murphy D A, Armour J A
Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
J Thorac Cardiovasc Surg. 1992 Nov;104(5):1383-7.
We studied in anesthetized dogs, the effects of cardiopulmonary bypass with normothermic whole blood, crossclamping of the aortic root, and continuous warm blood cardioplegia on the ability of the efferent sympathetic nervous system to augment the heart and that of the efferent parasympathetic nervous system to depress the heart. In control states, heart rate, atrial force of contraction, and right and left ventricular wall systolic pressures were augmented by stimulation of the intrathoracic efferent sympathetic nervous system and by administration of isoproterenol into the systemic circulation. After 1 hour of normothermic cardiopulmonary bypass that utilized aortic crossclamping and continuous perfusion of the coronary arteries with normothermic blood (20 mEq/L potassium), cardiac-augmenting effects induced by the efferent sympathetic nervous system and by isoproterenol were similar. Depressive responses elicited by the efferent parasympathetic nervous system were also unaffected by these procedures. Continuous warm blood cardioplegia does not result in impairment of the efferent sympathetic nervous system regulating the heart.
我们在麻醉犬身上研究了常温全血体外循环、主动脉根部交叉钳夹以及持续温血心脏停搏液对传出交感神经系统增强心脏功能的能力和传出副交感神经系统抑制心脏功能的能力的影响。在对照状态下,刺激胸内传出交感神经系统以及向体循环中注入异丙肾上腺素可使心率、心房收缩力以及左右心室壁收缩压增强。在利用主动脉交叉钳夹并持续用常温血(钾浓度20 mEq/L)灌注冠状动脉进行1小时常温体外循环后,传出交感神经系统和异丙肾上腺素所诱导的心脏增强效应相似。传出副交感神经系统所引发的抑制反应也不受这些操作的影响。持续温血心脏停搏液不会导致调节心脏的传出交感神经系统受损。