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猫体外循环的肺和血流动力学效应以及前列环素的有益作用。

Pulmonary and haemodynamic effects of extracorporeal circulation in the cat and the beneficial effects of prostacyclin.

作者信息

Jahr J, Grände P O

机构信息

Department of Physiology and Biophysics, University of Lund, Sweden.

出版信息

Intensive Care Med. 1992;18(2):118-22. doi: 10.1007/BF01705045.

Abstract

Side-effects of a veno-venous extracorporeal system and possible beneficial effects of prostacyclin (epoprostenol) are analyzed on the cat. Three groups were studied; one control group without extracorporeal circulation and two groups with an extracorporeal flow of 10-12 ml/kg/min, one of which was given prostacyclin (70-110 ng/kg/min). The extracorporeal circulation triggered a decrease in arterial saturation (from 99 to 91%) and carbon dioxide elimination (increase in arterial to end-tidal PCO2 by about 1 kpa) a metabolic acidosis (pH approximately 7.20), a platelet consumption (approximately 50%) and shortened survival time, side-effects reduced by prostacyclin. Further, there was a marked increase in haemoglobin concentration indicating hypovolemia via capillary fluid filtration. None of these side-effects were seen in the control group. Extracorporeal circulation as a trigger for pulmonary dysfunction and for impaired tissue nutrition with possible beneficial effects of prostacyclin is discussed, and also form a clinical point of view (i.e. extracorporeal lung assistance, ECLA), on the basis of the results.

摘要

对猫分析了静脉-静脉体外循环系统的副作用以及前列环素(依前列醇)可能的有益作用。研究了三组;一组为无体外循环的对照组,两组体外血流量为10 - 12毫升/千克/分钟,其中一组给予前列环素(70 - 110纳克/千克/分钟)。体外循环引发动脉血氧饱和度下降(从99%降至91%)和二氧化碳排出减少(动脉血与呼气末二氧化碳分压增加约1千帕)、代谢性酸中毒(pH约为7.20)、血小板消耗(约50%)以及生存时间缩短,前列环素可减轻这些副作用。此外,血红蛋白浓度显著升高,表明通过毛细血管液体滤过出现了血容量不足。对照组未出现这些副作用。基于研究结果,讨论了体外循环作为肺功能障碍和组织营养受损的诱因以及前列环素可能的有益作用,还从临床角度(即体外肺辅助,ECLA)进行了探讨。

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