Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Pediatr Res. 2012 Mar;71(3):241-6. doi: 10.1038/pr.2011.48. Epub 2012 Jan 11.
There is little information regarding the comparative hemodynamic effects of adding milrinone or levosimendan to dopamine infusion in hypoxia-reoxygenated (H-R) newborns.
Severely hypoxic piglets had cardiogenic shock with depressed cardiac index (CI) and mean arterial pressure (MAP). The hemodynamics deteriorated gradually after initial recovery upon reoxygenation. Heart rate and CI improved with milrinone (D+M) and levosimendan (D+L) administration (P < 0.05 vs. control). Both regimens improved carotid arterial flow and carotid vascular resistance; D+M additionally improved superior mesentric arterial flow (all P < 0.05 vs. control). No effect was found on renal arterial flow or elevated lactate state with either regimen. D+M piglets also had a lower myocardial oxidized/reduced glutathione ratio (P < 0.05 vs. control).
In conclusion, adding milrinone or levosimendan to dopamine similarly improved systemic hemodynamics in H-R newborn piglets. Milrinone also improved mesenteric perfusion and attenuated myocardial oxidative stress.
Twenty-eight piglets (1-4 d, 1.5-2.5 kg) were instrumented for continuous monitoring of systemic MAP and pulmonary arterial pressure (PAP), CI, and carotid, superior mesenteric, and renal arterial flows. Piglets were randomized with blinding to sham-operated, H-R control (saline), and H-R dopamine (10 μg/kg/min) with D+M or D+L groups. H-R piglets underwent H-R followed by 2 h of drug infusion after reoxygenation. Tissue was collected for biochemical/oxidative stress testing and histological analysis.
关于在缺氧再复氧（H-R）新生儿中添加米力农或左西孟旦与多巴胺输注相比的比较血流动力学效应的信息很少。
严重低氧的小猪有心源性休克，伴有心指数（CI）和平均动脉压（MAP）降低。复氧后最初恢复后，血液动力学逐渐恶化。米力农（D+M）和左西孟旦（D+L）给药可改善心率和 CI（P<0.05 与对照组相比）。两种方案均改善颈动脉血流和颈动脉血管阻力；D+M 还改善肠系膜上动脉血流（均 P<0.05 与对照组相比）。两种方案均未发现肾动脉血流或升高的乳酸状态有任何变化。D+M 组的心肌氧化/还原谷胱甘肽比值也较低（P<0.05 与对照组相比）。
总之，在 H-R 新生小猪中，添加米力农或左西孟旦与多巴胺类似地改善全身血液动力学。米力农还改善肠系膜灌注并减轻心肌氧化应激。
28 只小猪（1-4 天，1.5-2.5 公斤）接受了连续监测全身 MAP 和肺动脉压（PAP）、CI 以及颈动脉、肠系膜上动脉和肾动脉血流的仪器。小猪随机分组，接受假手术、H-R 对照组（盐水）和 H-R 多巴胺（10μg/kg/min）与 D+M 或 D+L 组。H-R 小猪经历 H-R，然后在复氧后进行 2 小时的药物输注。收集组织进行生化/氧化应激测试和组织学分析。
