Fujii Yoshitaka, Uemura Aki
First Department of Anesthesiology, Toho University School of Medicine, Tokyo, Japan.
Department of Anesthesiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan.
Curr Ther Res Clin Exp. 2010 Jun;71(3):154-61. doi: 10.1016/j.curtheres.2010.06.001.
Hypercapnia is associated with diaphragm muscle dysfunction that causes a reduction of diaphragmatic force generated for a constant elective myographic activity. No published data are available concerning hypercapnic depression of diaphragmatic contractility during dibutyryl cyclic adenosine monophospate (DBcAMP) administration.
The aim of this study was to assess the effects of DBcAMP on hypercapnic depression of diaphragmatic contractility in pentobarbital-anesthetized dogs.
This experimental study was conducted from July to December 2008 at the Department of Anesthesiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan. Adult (aged >5 years) mongrel dogs weighing 10 to 15 kg were randomly divided into 3 equal groups. Hypercapnia (80-90 mm Hg) was induced with 10% carbon dioxide added to the inspired gas. When hypercapnia was established, group 1 was infused with low-dose DBcAMP (0.05 mg/kg/min); group 2 was infused with high-dose DBcAMP (0.2 mg/kg/min); and group 3 received placebo (saline). Study drug was administered intravenously for 60 minutes. Diaphragmatic contractility was assessed by transdiaphragmatic pressure (Pdi) at baseline, induction of hypercapnia, and study drug administration.
Twenty-one dogs were divided into 3 groups of 7. There were no significant differences observed at baseline. In the presence of hypercapnia, Pdi (mean [SD], cm H2O) at low- (20-Hz) and high-frequency (100-Hz) stimulation was significantly decreased from baseline in each group (all, P = 0.001). In groups 1 and 2, Pdi at both stimuli was significantly increased during DBcAMP administration compared with hypercapnia-induced values (group 1: 20-Hz, 13.5 [2.2] vs 15.0 [2.4], respectively, P = 0.001, 100-Hz, 21.2 [1.6] vs 22.5 [1.6], P = 0.001; group 2: 20-Hz, 13.7 [1.4] vs 19.2 [1.7], P = 0.001, 100-Hz, 21.0 [2.4] vs 27.2 [2.5], P = 0.001). The Pdi at both stimuli during DBcAMP administration was significantly higher in group 2 than in group 1 (20-Hz, 19.2 [1.7] vs 15.0 [2.4], P = 0.001, 100-Hz, 27.2 [2.5] vs 22.5 [1.6], P = 0.003). In group 3, Pdi did not significantly change in regard to either stimulus from hypercapnia-induced values.
DBcAMP, in a dose-dependent manner, was associated with improved hypercapnic depression of diaphragmatic contractility in these pentobarbital-anesthetized dogs.
高碳酸血症与膈肌功能障碍相关,膈肌功能障碍会导致在恒定的随意肌电图活动下产生的膈肌力量降低。关于在给予二丁酰环磷腺苷(DBcAMP)期间高碳酸血症对膈肌收缩力的抑制作用,尚无已发表的数据。
本研究旨在评估DBcAMP对戊巴比妥麻醉犬高碳酸血症所致膈肌收缩力抑制的影响。
本实验研究于2008年7月至12月在日本筑波大学临床医学研究所麻醉科进行。体重10至15千克的成年(年龄>5岁)杂种犬被随机分为3组,每组数量相等。通过在吸入气体中添加10%二氧化碳诱导高碳酸血症(80 - 90毫米汞柱)。当建立高碳酸血症后,第1组静脉输注低剂量DBcAMP(0.05毫克/千克/分钟);第2组静脉输注高剂量DBcAMP(0.2毫克/千克/分钟);第3组接受安慰剂(生理盐水)。研究药物静脉给药60分钟。在基线、诱导高碳酸血症时以及给予研究药物时,通过跨膈压(Pdi)评估膈肌收缩力。
21只犬被分为3组,每组7只。在基线时未观察到显著差异。在高碳酸血症状态下,每组在低频(20赫兹)和高频(100赫兹)刺激时的Pdi(平均值[标准差],厘米水柱)均较基线显著降低(均为P = 0.001)。在第1组和第2组中,与高碳酸血症诱导值相比,在给予DBcAMP期间两种刺激下的Pdi均显著增加(第1组:20赫兹时,分别为13.5[2.2]对15.0[2.4],P = 0.001,100赫兹时,21.2[1.6]对22.5[1.6],P = 0.001;第2组:20赫兹时,13.7[1.4]对19.2[1.7],P = 0.001,100赫兹时,21.0[2.4]对27.2[2.5],P = 0.001)。在给予DBcAMP期间,第2组两种刺激下的Pdi均显著高于第1组(20赫兹时,19.2[1.7]对15.0[2.4],P = 0.001,100赫兹时,27.2[2.5]对22.5[1.6],P = 0.003)。在第3组中,与高碳酸血症诱导值相比,两种刺激下的Pdi均无显著变化。
在这些戊巴比妥麻醉犬中,DBcAMP以剂量依赖的方式改善了高碳酸血症对膈肌收缩力的抑制作用。