Berk J L, Hagen J F, Tong R K, Levy M L, Martin P J
Surgery. 1977 Sep;82(3):366-72.
Recent studies have shown that epinephrine (E), norepinephrine (NE), and isoproterenol (I) caus'e substantial pulmonary shunting. This study was undertaken to determine the role of alpha (pulmonary vasconconstriction) and beta (pulmonary vasodilatation) adrenergic stimulation in the pathogenesis of pulmonary insufficiency. Forty-three mechanically ventilated, anesthetized dogs received infusions of E, alpha and beta stimulant; NE, a relatively pure alpha stimulant; I, a relatively pure beta stimulant; and dextran (D), a drug with no known adrenergic activity. The cardiac output and shunt measurements were determined simultaneously in the control period and four times during a 1 hour infusion. The quadratic equation of best fit was determined for each group for the relationship between the cardiac output and the shunt over a wide range of cardiac outputs, and statistical comparisons were made between all groups of the shunt at the same cardiac output. In all groups an increase in cardiac output was associated with an increase in the shunt, but the magnitude of the increase in the shunt differed significantly with each drug over the entire range, being smallest with D and becoming progressively larger with I, E, and NE, respectively. It is concluded that an increase in the pulmonary blood flow causes an increase in the pulmonary shunt, but that the magnitude of the increase is dependent on the specific pulmonary microcirculatory effects of each drug.
最近的研究表明，肾上腺素（E）、去甲肾上腺素（NE）和异丙肾上腺素（I）会导致大量肺内分流。本研究旨在确定α（肺血管收缩）和β（肺血管舒张）肾上腺素能刺激在肺功能不全发病机制中的作用。43只接受机械通气的麻醉犬接受了E（α和β兴奋剂）、NE（相对纯的α兴奋剂）、I（相对纯的β兴奋剂）和右旋糖酐（D，一种无已知肾上腺素能活性的药物）的输注。在对照期以及1小时输注期间的4个时间点同时测定心输出量和分流情况。针对每组在广泛的心输出量范围内确定心输出量与分流之间关系的最佳拟合二次方程，并对相同心输出量时所有组的分流情况进行统计学比较。在所有组中，心输出量增加均与分流增加相关，但在整个范围内，每种药物引起的分流增加幅度差异显著，以D组最小，I、E和NE组的增幅则逐渐增大。结论是肺血流量增加会导致肺内分流增加，但增加的幅度取决于每种药物对肺微循环的特定作用。
