Miura M, Okada K
Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka.
Masui. 1991 Dec;40(12):1825-37.
The effects of dobutamine (DOB) on hemodynamics, critical cooling, and myocardial excitability were studied in dogs under simple deep hypothermia. Hypothermia was induced by surface cooling after the animals had been anesthetized with ether and triflupromazine (conventional method, group I). Continuous intravenous administration of DOB was combined with conventional method in group II, and surface cooling was performed with thiamylal in group III. The following results were obtained. The mean lowest temperature reached was 15.6 degrees C in group II. MAP, CO and V max of group II were maintained significantly higher than those of group I during cooling. Decrease in BE in group II was mild compared with group I. Catecholamine release during cooling was suppressed completely in group I and II, but increased markedly in group III. Myocardial threshold to artificial pacing in group II was elevated as the temperature fell, and restored during rewarming, while that of group III was unchanged during cooling. Ventricular fibrillation occurred by stimulation of pacemakers in some cases. Our results suggest that even in case of hypothermia, DOB retains a selective inotropic effect with no threat of arrhythmogenicity, and produces stable hemodynamics. These characteristics of DOB allow cooling down to 15 degrees C.
在单纯深度低温状态下,研究了多巴酚丁胺(DOB)对犬血流动力学、临界体温降低及心肌兴奋性的影响。动物用乙醚和三氟拉嗪麻醉后,通过体表降温诱导低温(传统方法,I组)。II组将持续静脉输注DOB与传统方法相结合,III组用硫喷妥钠进行体表降温。获得以下结果。II组达到的平均最低温度为15.6℃。II组在降温期间的平均动脉压(MAP)、心输出量(CO)和最大上升速率(V max)显著高于I组。与I组相比,II组碱剩余(BE)的降低较为轻微。I组和II组在降温期间儿茶酚胺释放完全受到抑制,但III组显著增加。II组心肌对人工起搏的阈值随温度下降而升高,并在复温期间恢复,而III组在降温期间无变化。在某些情况下,刺激起搏器会发生心室颤动。我们的结果表明,即使在低温情况下,DOB仍保留选择性正性肌力作用,无致心律失常风险,并产生稳定的血流动力学。DOB的这些特性允许体温降至15℃。