Lim Choon Hak, Son Ho Sung, Fang Yung Hu, Lee Jung Joo, Lee Hye Won, Sun Kyung
Department of Anesthesiology and Pain Medicine, Korea University, Seoul, Korea.
ASAIO J. 2007 Nov-Dec;53(6):791-4. doi: 10.1097/MAT.0b013e318158e930.
The generation of pulsatile flow depends on the hemodynamic energy gradient rather than the pressure gradient. We hypothesized that either positive or negative inotropic agents can affect the hemodynamic energy, which can be measured using the energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE). This study examined the change in hemodynamic energy induced by dopamine, epinephrine, and esmolol infusion in terms of the EEP and SHE. Dopamine (5, 10 microg/kg/min), epinephrine (0.02, 0.1 microg/kg/min) and esmolol (after bolus 1 mg/kg, 0.1, 0.3 mg/kg/min) were infused into six anesthetized dogs. The hemodynamic parameters were collected in the descending thoracic aorta. The mean arterial pressure, blood flow, EEP, and SHE increased significantly with the dopamine infusion. The mean arterial pressure and EEP decreased significantly after the esmolol infusion, while it increased after the epinephrine infusion (p < 0.05 respectively). There was a correlation between the EEP and flow on the descending aorta during the dopamine, esmolol and epinephrine infusions (p < 0.05 respectively). In conclusion, the change in hemodynamic energy induced by dopamine, esmolol, and epinephrine may be expressed in terms of the EEP and SHE. In addition, there was a strong correlation between the EEP and flow.
搏动性血流的产生取决于血流动力学能量梯度而非压力梯度。我们假设正性或负性肌力药物均可影响血流动力学能量，这可以通过能量等效压力（EEP）和剩余血流动力学能量（SHE）来测量。本研究根据EEP和SHE检测了多巴胺、肾上腺素和艾司洛尔输注引起的血流动力学能量变化。将多巴胺（5、10微克/千克/分钟）、肾上腺素（0.02、0.1微克/千克/分钟）和艾司洛尔（在静脉推注1毫克/千克后，0.1、0.3毫克/千克/分钟）输注到6只麻醉犬体内。在降主动脉收集血流动力学参数。输注多巴胺后，平均动脉压、血流量、EEP和SHE显著增加。输注艾司洛尔后平均动脉压和EEP显著降低，而输注肾上腺素后则升高（分别为p < 0.05）。在输注多巴胺、艾司洛尔和肾上腺素期间，降主动脉处的EEP与血流量之间存在相关性（分别为p < 0.05）。总之，多巴胺、艾司洛尔和肾上腺素引起的血流动力学能量变化可以用EEP和SHE来表示。此外，EEP与血流量之间存在强相关性。
