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正常和脓毒症机械通气大鼠的胸膜下微血管血流速度和剪切率

Subpleural microvascular flow velocities and shear rates in normal and septic mechanically ventilated rats.

作者信息

Waisman Dan, Abramovich Amir, Brod Vera, Lavon Ofir, Nurkin Steven, Popovski Faina, Rotschild Avi, Bitterman Haim

机构信息

Ischemia-Shock Research Laboratory, Carmel Medical Center, The Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 34362, Israel.

出版信息

Shock. 2006 Jul;26(1):87-94. doi: 10.1097/01.shk.0000215317.22113.b2.

Abstract

Changes in pulmonary microhemodynamics are important variables in a large variety of pathological processes. We used in vivo fluorescent videomicroscopy of the subpleural microvasculature in mechanically ventilated rats to directly monitor microvascular flow velocity (FV) and shear rate in pulmonary arterioles, capillaries, and venules in healthy rats and in septic rats 20 h after cecal ligation and puncture (CLP). Observations were made through a small thoracotomy after injection of fluorescent microspheres (D = 1 microm) into the systemic circulation. The FVs were calculated off-line by frame-by-frame measurements of the distance covered by individual microspheres per unit of time. In healthy rats, inspiratory FV were 1322 +/- 142 microm/s in subpleural arterioles and 599 +/- 25 microm/s in capillaries. The highest FV was found in venules (1552 +/- 132 microm/s). The calculated shear rates were 547 +/- 62/s in arterioles and 619 +/- 19/s in capillaries. The highest shear rates were detected in venules (677 +/- 59/s). No significant changes in FV and shear rates were observed throughout the 1-h observation period in any of the microvascular compartments. Pulmonary microvascular FV and shear rates found in sham-operated rats in the CLP experiments were not significantly different from values of healthy rats. The CLP caused a significant increase in leukocyte sequestration in the lungs and a mean of 27% to 34% decrease in FV in all sections of the pulmonary microvasculature (P < 0.001 in capillaries and P < 0.05 in venules). Also, CLP caused a 23% decrease in capillary shear rate that reached only borderline statistical significance (P < 0.06) and a significant 35% decrease in mean shear rate in venules (P < 0.05). Fluorescent videomicroscopy is offered as a stable and reproducible method for in vivo determinations of pulmonary microhemodynamics in clinically relevant models of sepsis.

摘要

肺微血管动力学变化是多种病理过程中的重要变量。我们利用体内荧光视频显微镜观察机械通气大鼠胸膜下微血管系统,以直接监测健康大鼠以及盲肠结扎穿孔(CLP)术后20小时脓毒症大鼠肺小动脉、毛细血管和小静脉中的微血管流速(FV)和剪切率。在将荧光微球(直径1微米)注入体循环后,通过小切口开胸进行观察。FV通过逐帧测量单个微球在单位时间内移动的距离离线计算得出。在健康大鼠中,胸膜下小动脉的吸气FV为1322±142微米/秒,毛细血管为599±25微米/秒。小静脉中FV最高(1552±132微米/秒)。计算得出的小动脉剪切率为547±62/秒,毛细血管为619±19/秒。小静脉中剪切率最高(677±59/秒)。在1小时观察期内,任何微血管区域的FV和剪切率均未观察到显著变化。CLP实验中假手术大鼠的肺微血管FV和剪切率与健康大鼠的值无显著差异。CLP导致肺内白细胞滞留显著增加,肺微血管所有节段的FV平均降低27%至34%(毛细血管中P<0.001,小静脉中P<0.05)。此外,CLP导致毛细血管剪切率降低23%,仅达到临界统计学意义(P<0.06),小静脉平均剪切率显著降低35%(P<0.05)。荧光视频显微镜被认为是一种在脓毒症临床相关模型中体内测定肺微血管动力学的稳定且可重复的方法。

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