兰地洛尔，一种超短效β1 受体阻滞剂，可改善肾上腺素心肺复苏后大鼠的肺水肿。

Landiolol, an ultra short acting beta1-blocker, improves pulmonary edema after cardiopulmonary resuscitation with epinephrine in rats.

机构信息

Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.

出版信息

J Anesth. 2010 Feb;24(1):67-72. doi: 10.1007/s00540-009-0834-4. Epub 2009 Dec 29.

DOI:10.1007/s00540-009-0834-4

PMID:20039077

Abstract

PURPOSE

Epinephrine is frequently administered as an essential drug for cardiopulmonary resuscitation (CPR) in clinical situations. Unfortunately, epinephrine elicits unfavorable effects, for example pulmonary edema, both during and after CPR. We hypothesized that administration of landiolol during CPR with epinephrine would reduce the degree of pulmonary edema and improve survival. Therefore using a rat CPR model, we investigated the effect of landiolol with epinephrine on pulmonary and cardiac injury following CPR.

METHODS

Twelve male Sprague-Dawley rats were allocated to Group-E (Gr.-E: 0.02 mg/kg epinephrine) and thirteen animals to Group-EL (Gr.-EL: 0.02 mg/kg epinephrine with 0.5 mg/kg landiolol). After tracheotomy, cardiac arrest was induced by obstructing the endotracheal tube. We measured the lung wet-to-dry (W/D) weight ratio to evaluate the degree of pulmonary edema 2 h after CPR. The hematocrit (Hct) difference between before and after CPR (Hct-D) was calculated. We measured the plasma levels of troponin-I (T-I) to evaluate the degree of cardiac injury.

RESULTS

The lung W/D weight ratio in Gr.-E (6.4 +/- 1.06, mean +/- SD) was significantly higher than that for Gr.-EL (4.9 +/- 0.80, p < 0.01). Hct-D was significantly higher in Gr.-E (10.2 +/- 3.1%) than in Gr.-EL (5.2 +/- 3.5%, p < 0.01). We observed no difference in survival or difference of T-I. (Gr.-E: 2.62 +/- 0.51 ng/ml, Gr.-EL: 3.43 +/- 2.72 ng/ml).

CONCLUSION

Administration of landiolol during CPR with epinephrine prevented the development of pulmonary edema and the increase in Hct during and after CPR.

摘要

目的

肾上腺素常作为心肺复苏（CPR）的基本药物在临床情况下使用。不幸的是，肾上腺素在 CPR 期间和之后会引起不利影响，例如肺水肿。我们假设在 CPR 中给予艾司洛尔和肾上腺素可以减轻肺水肿的程度并提高生存率。因此，我们使用大鼠 CPR 模型，研究了艾司洛尔和肾上腺素对 CPR 后肺和心脏损伤的影响。

方法

将 12 只雄性 Sprague-Dawley 大鼠分配到肾上腺素组（Gr.-E：0.02mg/kg 肾上腺素），13 只动物分配到艾司洛尔和肾上腺素组（Gr.-EL：0.02mg/kg 肾上腺素和 0.5mg/kg 艾司洛尔）。气管切开后，通过阻塞气管内管诱导心脏骤停。我们测量肺湿重/干重（W/D）比值来评估 CPR 后 2 小时肺水肿的程度。计算 CPR 前后血细胞比容（Hct）的差值（Hct-D）。我们测量肌钙蛋白 I（T-I）的血浆水平来评估心脏损伤的程度。

结果

Gr.-E 组（6.4±1.06，平均值±标准差）的肺 W/D 重量比值明显高于 Gr.-EL 组（4.9±0.80，p<0.01）。Gr.-E 组的 Hct-D（10.2±3.1%）明显高于 Gr.-EL 组（5.2±3.5%，p<0.01）。两组的生存率或 T-I 没有差异。（Gr.-E：2.62±0.51ng/ml，Gr.-EL：3.43±2.72ng/ml）。