Sandin R, Wahlberg J, Modig J
Department of Anaesthesiology, University Hospital, Uppsala, Sweden.
Acta Anaesthesiol Scand. 1991 Aug;35(6):469-77. doi: 10.1111/j.1399-6576.1991.tb03331.x.
Porcine and human renal physiology are similar in important aspects. Renal cortical microcirculation and its relation to inulin clearance (CIn) was therefore studied before and after renal ischaemia in 28 pigs under continuous intravenous chlormethiazole-pancuronium anaesthesia. The anaesthesia used provided essential stability in central haemodynamics. The animals were studied for 90 min of reperfusion following 0, 30 or 60 min of renal ischaemia. Twelve of the animals (four were subjected to each duration of ischemia) were also studied 18 h after start of reperfusion. Regional blood flow in the superficial renal cortex was measured by laser Doppler flowmetry (LDF), and tissue oxygenation (PtO2) by surface microelectrode technique. These techniques allow continuous or repeated measurements. During the first 90 min of reperfusion, superficial renal cortical blood flow measured by LDF (Qsrc) underwent considerable temporal variation which followed a certain pattern. Thus, when the renal arterial blood flow was restored after ischaemia, we observed an instant peak in Qsrc followed by a decreasing flow until a minimum value (Qmin) was reached between 3 and 9 min after start of reperfusion (tQmin). Thereafter, Qsrc increased until a maximal value (Qmax) was reached between 11 and 64 min after start of reperfusion (tQmax). The parameters tQmin and tQmax were related to inulin clearance 18 h after start of reperfusion (P less than 0.05 and P less than 0.01, respectively). Thus, it might be possible soon after start of reperfusion--to evaluate the severity of ischaemic damage. This could be useful in the evaluation of different prophylactic strategies, since the full extent of the ischaemic damage, as assessed by clearance determinations, cannot be established until hours later.(ABSTRACT TRUNCATED AT 250 WORDS)
猪和人的肾脏生理在重要方面相似。因此，在连续静脉注射氯美噻唑-泮库溴铵麻醉下，对28头猪肾缺血前后的肾皮质微循环及其与菊粉清除率（CIn）的关系进行了研究。所用麻醉在中心血流动力学方面提供了基本稳定性。在肾缺血0、30或60分钟后，对动物进行90分钟的再灌注研究。其中12只动物（每种缺血持续时间4只）在再灌注开始18小时后也进行了研究。用激光多普勒血流仪（LDF）测量浅表肾皮质的局部血流，用表面微电极技术测量组织氧合（PtO2）。这些技术允许进行连续或重复测量。在再灌注的最初90分钟内，用LDF测量的浅表肾皮质血流（Qsrc）经历了相当大的时间变化，且遵循一定模式。因此，当缺血后恢复肾动脉血流时，我们观察到Qsrc瞬间达到峰值，随后血流下降，直到再灌注开始后3至9分钟之间达到最小值（Qmin）（tQmin）。此后，Qsrc增加，直到再灌注开始后11至64分钟之间达到最大值（Qmax）（tQmax）。参数tQmin和tQmax与再灌注开始18小时后的菊粉清除率相关（分别为P<0.05和P<0.01）。因此，在再灌注开始后不久有可能评估缺血损伤的严重程度。这在评估不同的预防策略时可能有用，因为通过清除率测定评估的缺血损伤的全部程度直到数小时后才能确定。（摘要截短至250字）
