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高碳酸血症和低氧性高碳酸血症期间的局部静脉流出、血容量和交感神经活动。

Regional venous outflow, blood volume, and sympathetic nerve activity during hypercapnia and hypoxic hypercapnia.

作者信息

Hoka S, Arimura H, Bosnjak Z J, Kampine J P

机构信息

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226.

出版信息

Can J Physiol Pharmacol. 1992 Jul;70(7):1032-9. doi: 10.1139/y92-142.

Abstract

We examined the changes in systemic blood volume and regional venous outflow from the splanchnic, coronary, and other remaining vascular beds in response to acute hypercapnia or hypoxic hypercapnia in dogs, using cardiopulmonary bypass and a reservoir. Hypercapnia (PCO2 = 105 mmHg) (1 mmHg = 133 Pa) and hypoxic hypercapnia (PO2 = 23 mmHg, PCO2 = 99 mmHg) caused marked decreases in systemic blood volume of 14 +/- 3 and 16 +/- 3 mL/kg in spleen-intact dogs, and 3 +/- 2 and 10 +/- 2 mL/kg in splenectomized dogs, respectively. Splanchnic venous outflow increased by 12% at 3.5 min hypercapnia, whereas it decreased by 60% at 3.5 min hypoxic hypercapnia. Coronary venous outflow increased by 85 and 400% at 3.5 min hypercapnia and hypoxic hypercapnia, respectively. Sympathetic efferent nerve activity revealed a significant augmentation during hypoxic hypercapnia and a relatively smaller increase (30% of the response to hypoxic hypercapnia) during hypercapnia. Carotid and aortic chemoreceptor and baroreceptor denervation attenuated significantly the response of systemic blood volume to hypercapnia and hypoxic hypercapnia. The regional venous outflow responses to hypercapnia were not altered after chemodenervation, but those to hypoxic hypercapnia were significantly attenuated after chemodenervation. These results suggest that acute hypercapnia and hypoxic hypercapnia caused a marked decrease in vascular capacitance owing primarily to an increase in sympathetic efferent nerve activity via chemoreceptor stimulation. They also indicate that blood flow to the splanchnic vascular bed during hypercapnia increased (even though the cardiac output was constant), whereas it increased to the extrasplanchnic and coronary vascular beds during hypoxic hypercapnia.

摘要

我们使用体外循环和一个储液器,研究了犬在急性高碳酸血症或低氧性高碳酸血症时,全身血容量以及来自内脏、冠脉和其他剩余血管床的局部静脉流出量的变化。高碳酸血症(PCO2 = 105 mmHg)(1 mmHg = 133 Pa)和低氧性高碳酸血症(PO2 = 23 mmHg,PCO2 = 99 mmHg)分别导致脾脏完整的犬全身血容量显著减少,分别为14±3 mL/kg和16±3 mL/kg,而脾切除的犬分别为3±2 mL/kg和10±2 mL/kg。在高碳酸血症3.5分钟时,内脏静脉流出量增加了12%,而在低氧性高碳酸血症3.5分钟时,其减少了60%。在高碳酸血症和低氧性高碳酸血症3.5分钟时,冠脉静脉流出量分别增加了85%和400%。交感传出神经活动在低氧性高碳酸血症时显著增强,在高碳酸血症时增加相对较小(为低氧性高碳酸血症反应的30%)。颈动脉和主动脉化学感受器及压力感受器去神经支配显著减弱了全身血容量对高碳酸血症和低氧性高碳酸血症的反应。化学去神经支配后,对高碳酸血症的局部静脉流出量反应未改变,但对低氧性高碳酸血症的反应在化学去神经支配后显著减弱。这些结果表明,急性高碳酸血症和低氧性高碳酸血症主要通过化学感受器刺激导致交感传出神经活动增加,从而引起血管容量显著降低。它们还表明,高碳酸血症时流向内脏血管床的血流量增加(尽管心输出量恒定),而低氧性高碳酸血症时流向内脏外和冠脉血管床的血流量增加。

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