Kawamoto M, Suzuki N, Takasaki M
Department of Anesthesiology, Miyazaki Medical College, Japan.
Anesth Analg. 1992 May;74(5):747-52. doi: 10.1213/00000539-199205000-00021.
Intravenous liquid halothane causes severe pulmonary edema when administered for suicide attempts. This study was carried out to elucidate the cardiopulmonary effects of intravenous liquid halothane in 14 dogs. Subjects were divided into three groups: group 1 (n = 4) was the control; group 2 (n = 5) received 7.5 mmol intravenous liquid halothane; and group 3 (n = 5) received pretreatment of continuous infusion of prostaglandin E1 at a rate of 0.02 microgram.kg-1.min-1, followed by 7.5 mmol intravenous liquid halothane. Hemodynamic values, extravascular lung water, and arterial blood gas tensions were measured for 240 min. In group 2, thromboxane B2, beta-glucuronidase, and lipid peroxides were measured in four of five dogs. In group 2, intravenous liquid halothane caused pulmonary edema associated with hypoxemia, pulmonary hypertension, and left ventricular dysfunction. In group 3, prostaglandin E1, given to reduce pulmonary vasoconstriction and left ventricular preload, aggravated hypoxemia and pulmonary hypertension and impaired left ventricular contractility, although end-diastolic left ventricular pressure was low. Thromboxane B2 increased, whereas beta-glucuronidase and lipid peroxides did not change after administration of intravenous halothane. We conclude that pulmonary edema induced by intravenous liquid halothane was due to direct pulmonary vascular damage, and that pulmonary vasoconstriction and increased left ventricular preload were not contributory causes.
静脉注射液态氟烷用于自杀未遂时会导致严重肺水肿。本研究旨在阐明静脉注射液态氟烷对14只犬心肺功能的影响。将实验对象分为三组:第一组(n = 4)为对照组;第二组(n = 5)静脉注射7.5 mmol液态氟烷;第三组(n = 5)先以0.02微克·千克⁻¹·分钟⁻¹的速率持续输注前列腺素E1进行预处理,随后静脉注射7.5 mmol液态氟烷。在240分钟内测量血流动力学值、血管外肺水和动脉血气张力。在第二组的五只犬中,对其中四只测量了血栓素B2、β - 葡萄糖醛酸酶和脂质过氧化物。在第二组中,静脉注射液态氟烷导致肺水肿,并伴有低氧血症、肺动脉高压和左心室功能障碍。在第三组中,给予前列腺素E1以减轻肺血管收缩和左心室前负荷,但尽管左心室舒张末期压力较低,却加重了低氧血症和肺动脉高压,并损害了左心室收缩力。静脉注射氟烷后,血栓素B2增加,而β - 葡萄糖醛酸酶和脂质过氧化物没有变化。我们得出结论,静脉注射液态氟烷所致肺水肿是由于肺血管直接损伤,肺血管收缩和左心室前负荷增加并非其成因。