Engoren Milo, Habib Robert H
Department of Anesthesiology, St. Vincent Mercy Medical Center, Toledo, OH 43608, USA.
Resuscitation. 2004 Mar;60(3):319-26. doi: 10.1016/j.resuscitation.2003.10.008.
Patients with septic shock commonly have myocardial dysfunction associated with lactic acid production and troponin I release. The purpose of this study was to evaluate the effects on intraaortic balloon pump (IABP) support on myocardial dysfunction.
Prospective, randomized controlled study.
Animal research laboratory.
Ten pigs had arterial, pulmonary arterial, and coronary catheters inserted. After receiving endotoxin infusion over 30 min, half the animals received IABP support.
Coronary sinus lactic acid levels (P< 0.05 for both 90 min versus baseline and 60 min versus baseline) and arterial lactic acid levels (P < 0.05 for both 90 min versus baseline and 60 min versus baseline) increased with time but did not differ between IABP and sham groups. While overall there was no difference with time in myocardial lactic acid consumption or production (calculated as arterial lactic acid level minus coronary sinus lactic acid level), the IABP group showed net myocardial lactic acid consumption at 90 min, while the sham group showed myocardial lactic acid production. Three of five animals in each group showed troponin I release. The levels were similar and did not differ between groups.
IABP had no benefits in this porcine model of endotoxemic shock.
感染性休克患者通常存在与乳酸生成及肌钙蛋白I释放相关的心肌功能障碍。本研究旨在评估主动脉内球囊反搏（IABP）支持对心肌功能障碍的影响。
前瞻性随机对照研究。
动物研究实验室。
给10头猪插入动脉、肺动脉及冠状动脉导管。在30分钟内输注内毒素后，一半动物接受IABP支持。
冠状动脉窦乳酸水平（90分钟与基线相比及60分钟与基线相比，P均<0.05）和动脉乳酸水平（90分钟与基线相比及60分钟与基线相比，P均<0.05）随时间升高，但IABP组与假手术组之间无差异。虽然总体上心肌乳酸消耗或生成（计算为动脉乳酸水平减去冠状动脉窦乳酸水平）随时间无差异，但IABP组在90分钟时显示心肌净乳酸消耗，而假手术组显示心肌乳酸生成。每组5只动物中有3只出现肌钙蛋白I释放。其水平相似，组间无差异。
在这种猪内毒素血症休克模型中，IABP无益处。
