Lluch M, Ruz A, Varo E, Rufián S, Valdivia J, Giménez A
Servicio de Anestesia, Hospital Universitario Reina Sofía, Córdoba.
Rev Esp Anestesiol Reanim. 1990 Jul-Aug;37(4):200-4.
An anesthetic model with isofluorane is reported, with the hemodynamic abnormalities induced in 10 pigs of Landrace breed undergoing orthotopic hepatic transplant with centrifugal pump. ECG, arterial blood pressure, central venous pressure, pulmonary artery pressure and rectal temperature were monitored in all the animals. Hemodynamic parameters were measured in four periods: a) baseline; b) preanhepatic phase; c) anhepatic phase, and d) after revascularization. After a period of hemodynamic stability in preanhepatic phase, there was a reduction in cardiac output (p less than 0.01) and stroke volume (p less than 0.05) and an increase in heart rate, which were maintained during the rest of the operation. Central venous pressure, pulmonary capillary pressure and mean arterial pressure remained constant. Throughout the process there was a progressive increase in systemic vascular resistances, particularly pulmonary vascular resistance which, together with mean pulmonary arterial pressure, showed a significant increase in the last phase. During the bypass period there was a significant reduction of temperature. It was concluded that satisfactory results in experimental liver transplant are achieved with isofluorane and venous bypass with centrifugal pump.
报道了一种使用异氟烷的麻醉模型,该模型用于10头接受原位肝移植且使用离心泵的长白猪,观察其诱导的血流动力学异常情况。对所有动物监测心电图、动脉血压、中心静脉压、肺动脉压和直肠温度。在四个阶段测量血流动力学参数:a)基线期;b)无肝前期;c)无肝期;d)血管再通后。在无肝前期血流动力学稳定一段时间后,心输出量降低(p<0.01),每搏输出量降低(p<0.05),心率增加,这些变化在手术剩余阶段持续存在。中心静脉压、肺毛细血管压和平均动脉压保持恒定。在整个过程中,全身血管阻力逐渐增加,特别是肺血管阻力,它与平均肺动脉压一起,在最后阶段显著增加。在体外循环期间,温度显著降低。得出结论,使用异氟烷和离心泵进行静脉旁路可在实验性肝移植中取得满意结果。