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多巴酚丁胺和去甲肾上腺素对异氟烷麻醉马驹的心肺影响。

The cardiopulmonary effects of dobutamine and norepinephrine in isoflurane-anesthetized foals.

作者信息

Craig Cary A, Haskins Steve C, Hildebrand Susan V

机构信息

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.

出版信息

Vet Anaesth Analg. 2007 Nov;34(6):377-87. doi: 10.1111/j.1467-2995.2006.00304.x. Epub 2007 Aug 13.

Abstract

OBJECTIVE

To evaluate the cardiovascular effects of norepinephrine (NE) and dobutamine (DB) in isoflurane-anesthetized foals.

STUDY DESIGN

Prospective laboratory study.

METHODS

Norepinephrine (0.05, 0.10, 0.20, and 0.40 microg kg(-1) minute(-1)) and dobutamine (2.5, 5.0, and 10 microg kg(-1) minute(-1)) were alternately administered to seven healthy, 1- to 2-week-old isoflurane-anesthetized foals. Arterial and pulmonary arterial blood pressure, right atrial pressure, pulmonary artery occlusion pressure, heart rate, body temperature, cardiac output, arterial and mixed venous blood pH, partial pressure of carbon dioxide, partial pressure of oxygen [arterial partial pressure of oxygen (PaO(2)) and mixed venous partial pressure of oxygen (PvO(2))], and packed cell volume were measured. Standard base excess, bicarbonate concentration, systemic and pulmonary vascular resistance, cardiac index (CI), stroke volume, left and right stroke work indices, oxygen delivery (DO(2)), consumption, and extraction were calculated. Results Norepinephrine infusion resulted in significant increases in arterial and pulmonary arterial pressure, systemic and pulmonary vascular resistance indices, and PaO(2); heart rate was decreased. Dobutamine infusion resulted in significant increases in heart rate, stroke volume index, CI, and arterial and pulmonary arterial blood pressure. Systemic and pulmonary vascular resistance indices were decreased while the ventricular stroke work indices increased. The PaO(2) decreased while DO(2) and oxygen consumption increased. Oxygen extraction decreased and PvO(2) increased.

CONCLUSIONS AND CLINICAL RELEVANCE

Norepinephrine primarily augments arterial blood pressure while decreasing CI. Dobutamine primarily augments CI with only modest increases in arterial blood pressure. Both NE and DB could be useful in the hemodynamic management of anesthetized foals.

摘要

目的

评估去甲肾上腺素(NE)和多巴酚丁胺(DB)对异氟烷麻醉马驹心血管系统的影响。

研究设计

前瞻性实验室研究。

方法

对7匹1至2周龄、健康的异氟烷麻醉马驹交替给予去甲肾上腺素(0.05、0.10、0.20和0.40微克/千克(-1)分钟(-1))和多巴酚丁胺(2.5、5.0和10微克/千克(-1)分钟(-1))。测量动脉血压和肺动脉血压、右心房压力、肺动脉闭塞压、心率、体温、心输出量、动脉血和混合静脉血的pH值、二氧化碳分压、氧分压[动脉血氧分压(PaO₂)和混合静脉血氧分压(PvO₂)]以及红细胞压积。计算标准碱剩余、碳酸氢盐浓度、体循环和肺循环血管阻力、心脏指数(CI)、每搏量、左和右每搏功指数、氧输送(DO₂)、氧消耗和氧摄取率。结果:输注去甲肾上腺素导致动脉血压和肺动脉血压、体循环和肺循环血管阻力指数以及PaO₂显著升高;心率降低。输注多巴酚丁胺导致心率、每搏量指数、CI以及动脉血压和肺动脉血压显著升高。体循环和肺循环血管阻力指数降低,而心室每搏功指数升高。PaO₂降低,而DO₂和氧消耗增加。氧摄取率降低,PvO₂升高。

结论及临床意义

去甲肾上腺素主要升高动脉血压,同时降低CI。多巴酚丁胺主要增加CI,而动脉血压仅适度升高。NE和DB在麻醉马驹的血流动力学管理中均可能有用。

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