Hodgson D S, Dunlop C I, Chapman P L, Grandy J L
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University, Fort Collins 80523.
Am J Vet Res. 1992 Jun;53(6):938-43.
Gastric dilatation was experimentally induced in 6 anesthetized dogs maintained with constant-dose isoflurane in oxygen. An intragastric balloon was used to distend the stomach with a constant 30 mm of Hg pressure for 3.5 hours. The PaCO2 was maintained between 35 and 45 mm of Hg, using intermittent positive-pressure ventilation. Cardiopulmonary measurements prior to stomach distension (baseline) were compared with measurements taken during 0.1, 0.5, 1.0, 1.5, 2.5, and 3.5 hours of stomach distension by analyzing the change from baseline in a randomized-block analysis with each dog as a block. After distending the stomach, cardiac index increased (P less than 0.01) from 1.5 to 3.5 hours. Stroke volume did not change, thus the increase in the cardiac index was attributable to an increase in heart rate. During inflation, increases were observed in systemic arterial, pulmonary arterial, and right atrial pressure. Respiratory frequency was unchanged; however, to maintain PaCO2 constant, it was necessary to progressively increase peak airway pressure. Although PaO2 tended to decrease during gastric dilation, the dogs were never hypoxemic. These results indicate that when our methods are used to maintain a constant anesthetic dose of isoflurane in oxygen, an observed increase in cardiovascular performance is expected. This differs from other studies in anesthetized dogs that have shown reduction in cardiovascular performance following gastric dilatation.
对6只吸入恒定剂量异氟烷并持续给氧麻醉的犬进行实验性胃扩张。使用胃内球囊以30 mmHg的恒定压力扩张胃3.5小时。采用间歇性正压通气使动脉血二氧化碳分压(PaCO₂)维持在35至45 mmHg之间。通过以每只犬为区组的随机区组分析,比较胃扩张前(基线)的心肺测量值与胃扩张0.1、0.5、1.0、1.5、2.5和3.5小时时的测量值,分析与基线相比的变化。胃扩张后,心脏指数在1.5至3.5小时增加(P<0.01)。每搏输出量未改变,因此心脏指数的增加归因于心率增加。在充气过程中,观察到体动脉压、肺动脉压和右心房压升高。呼吸频率未改变;然而,为维持PaCO₂恒定,有必要逐渐增加气道峰压。尽管胃扩张期间动脉血氧分压(PaO₂)有下降趋势,但犬从未出现低氧血症。这些结果表明,当采用我们的方法在氧气中维持异氟烷的恒定麻醉剂量时,预计会观察到心血管功能增强。这与其他对麻醉犬的研究不同,那些研究显示胃扩张后心血管功能会降低。