Hayashibe Y
Department of Thoracic Surgery, School of Medicine, Juntendo University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1990 Aug;91(8):1031-9.
In 8 mongrel dogs (weight 9-13 kg), we created a bidirectional cavopulmonary shunt through 4th intercostal thoracotomy. Positive end-expiratory pressure (PEEP) was added from 0cmH2O to 16cmH2O at the steps of 2cmH2O. The heart rate (HR), central venous pressure (CVP), pulmonary artery pressure (PAP), femoral artery pressure (FAP), pulmonary vascular resistance index (PVRI), and systemic vascular resistance index (SVRI) were measured as parameters of hemodynamics. Cardiac output (CO), pulmonary artery flow at proximal and distal site of this shunt (D-SF, P-SF) were measured using a magnetic flow meter. Blood gas analysis (PH, PaO2, PaCO2, HCO3-) were performed at the same time. HR had no significant change. CVP, PAP, PVRI, SVRI increased significantly (p less than 0.05, p less than 0.05, p less than 0.05, p less than 0.05) at 2cmH2O (9.2 +/- 2.5 mmHg), 10cmH2O), (29.3 +/- 5.5 mmHg), 4cmH2O (287 +2- 56 dyne.sec.cm-5.m2), and 8cmH2O (1298 +/- 156 dyne.sec.cm-5.m2) compared with 0cmH2O (87.3 +/- 2.6 mmHg, 26.8 +/- 3.4 mmHg, 240 +/- 29 dyne.sec.cm-5.m2, 1136 +/- 176 dyne.sec.cm-5.m2). FAP, CO, D-SF, P-SF decreased significantly (p less than 0.01, p less than 0.05, p less than 0.01, p less than 0.05) at 6cmH2O (129 +/- 7 mmHg), 2cmH2O(0.44 +/- 0.05 L/min), 2cmH2O(449 +/- 47 ml/min), and 8cmH2O(105 +/- 17 ml/min) compared with 0cmH2O(148 +/- 11 mmHg, 048 +/- 0.06 L/min, 471 +/- 44 ml/min, 132 +/- 19 ml/min). On blood gas analysis, PaO2 increased significantly (p less than 0.05) from 2cmH2O PEEP except PH, PaCO2, HCO3-. A mechanism for decline in D-SF was considered of being a secondary effect due to increase in CVP.(ABSTRACT TRUNCATED AT 250 WORDS)
在8只杂种犬（体重9 - 13千克）中，我们通过第4肋间开胸术建立了双向腔肺分流。呼气末正压（PEEP）从0cmH₂O以2cmH₂O的步长增加至16cmH₂O。测量心率（HR）、中心静脉压（CVP）、肺动脉压（PAP）、股动脉压（FAP）、肺血管阻力指数（PVRI）和体循环血管阻力指数（SVRI）作为血流动力学参数。使用电磁流量计测量心输出量（CO）以及该分流近端和远端的肺动脉血流量（D - SF、P - SF）。同时进行血气分析（PH、PaO₂、PaCO₂、HCO₃⁻）。HR无显著变化。与0cmH₂O（87.3 ± 2.6 mmHg、26.8 ± 3.4 mmHg、240 ± 29 dynes·sec·cm⁻⁵·m²、1136 ± 176 dynes·sec·cm⁻⁵·m²）相比，CVP、PAP、PVRI、SVRI在2cmH₂O（9.2 ± 2.5 mmHg）、10cmH₂O（29.3 ± 5.5 mmHg）、4cmH₂O（287 ± 56 dynes·sec·cm⁻⁵·m²）和8cmH₂O（1298 ± 156 dynes·sec·cm⁻⁵·m²）时显著升高（p < 0.05、p < 0.05、p < 0.05、p < 0.05）。FAP、CO、D - SF、P - SF在6cmH₂O（129 ± 7 mmHg）、2cmH₂O（0.44 ± 0.05 L/min）、2cmH₂O（449 ± 47 ml/min）和8cmH₂O（105 ± 17 ml/min）时与0cmH₂O（148 ± 11 mmHg、0.48 ± 0.06 L/min、471 ± 44 ml/min、132 ± 19 ml/min）相比显著降低（p < 0.01、p < 0.05、p < 0.01、p < 0.05）。在血气分析中，除PH、PaCO₂、HCO₃⁻外，从2cmH₂O PEEP起PaO₂显著升高（p < 0.05）。D - SF下降的机制被认为是CVP升高的继发效应。（摘要截断于250字）
