Pennsylvania State University, College of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State Hershey Medical Center, Hershey, PA, United States.
Respir Physiol Neurobiol. 2013 Mar 1;186(1):87-94. doi: 10.1016/j.resp.2012.12.006. Epub 2013 Jan 17.
During a hemorrhagic shock (HS), O2 uptake ( [Formula: see text] ) decreases as soon as the rate of O2 delivery ( [Formula: see text] ) drops below a "critical level", a response accounted for by the reduction in mitochondrial O2supply. In urethane-anesthetized rats, [Formula: see text] was decreased within 20min from 21.5 to 2.8mlmin(-1) by slowly withdrawing 18mlkg(-1) of blood. This led to a reduction in [Formula: see text] from 6.1 to 2.4mlmin(-1) (n=5, p<0.01). Decoupling mitochondrial oxidative activity by injecting 2,4-DNP (6mgkg(-1), iv) before HS elevated [Formula: see text] to 11.9±1.2mlmin(-1) (n=6, p<0.01), which remained above control HS values throughout most of the hemorrhage. This was associated with higher levels of O2 extraction, cardiac output and ventilation than in control HS. [Formula: see text] relationship was shifted upward and to the left following DNP. In conclusion, cellular and systemic mechanisms, decreasing O2demand, account for a large part of HS induced [Formula: see text] decline resulting in an additional reduction in [Formula: see text] .
在失血性休克(HS)期间,一旦氧输送率([Formula: see text])降至“临界水平”以下,O2摄取量([Formula: see text])就会下降,这一反应归因于线粒体 O2供应减少。在氨基甲酸乙酯麻醉的大鼠中,通过缓慢抽出 18ml/kg(-1)的血液,[Formula: see text]在 20min 内从 21.5 降至 2.8mlmin(-1)。这导致[Formula: see text]从 6.1 降至 2.4mlmin(-1)(n=5,p<0.01)。在 HS 之前注射 2,4-DNP(6mg/kg(-1),iv)以解偶联线粒体氧化活性,将[Formula: see text]升高至 11.9±1.2mlmin(-1)(n=6,p<0.01),在大部分出血期间,这一值均高于对照 HS 值。这与较高的 O2 提取、心输出量和通气量有关。与对照 HS 相比,DNP 后[Formula: see text]关系向上和向左移动。总之,降低 O2需求的细胞和全身机制解释了 HS 诱导的[Formula: see text]下降的很大一部分,导致[Formula: see text]进一步减少。