Nomoto Y, Kawamura M
Department of Anaesthesiology, Tokyo National Chest Hospital, Japan.
Can J Anaesth. 1989 May;36(3 Pt 1):273-7. doi: 10.1007/BF03010764.
The effects of nitroglycerin, dopamine and dobutamine on pulmonary gas exchange were determined in 21 adult patients during two-lung and one-lung ventilation. Nitroglycerin, in 1 microgram.kg-1.min-1, decreased cardiac index (CI) and PaO2 during both two- and one-lung ventilation, and increased in Qs/Qt during one-lung ventilation. There were no significant changes in the measured variables during infusion of dopamine, 5 microgram.kg-1.min-1. Dobutamine, 5 microgram.kg-1.min-1, increased CI and PaO2 did not change during two-lung ventilation. During one-lung ventilation, PaO2 increased from (mean value +/- SD) 168 +/- 46 to 201 +/- 52 mmHg (P less than 0.01) with dobutamine infusion. Qs/Qt decreased from 29.2 +/- 7.0 to 26.0 +/- 6.2 per cent (P less than 0.05) without any change in pulmonary vascular resistance index during one-lung ventilation. We conclude that dobutamine has advantages over dopamine and nitroglycerin during one-lung ventilation.
在21例成年患者双肺通气和单肺通气期间，测定了硝酸甘油、多巴胺和多巴酚丁胺对肺气体交换的影响。硝酸甘油以1微克·千克⁻¹·分钟⁻¹的剂量给药时，在双肺通气和单肺通气期间均降低心脏指数（CI）和动脉血氧分压（PaO₂），并在单肺通气期间增加分流率（Qs/Qt）。在输注5微克·千克⁻¹·分钟⁻¹的多巴胺期间，所测变量无显著变化。5微克·千克⁻¹·分钟⁻¹的多巴酚丁胺在双肺通气期间增加CI且PaO₂无变化。在单肺通气期间，输注多巴酚丁胺时，PaO₂从（平均值±标准差）168±46 mmHg升高至201±52 mmHg（P<0.01）。单肺通气期间，Qs/Qt从29.2±7.0%降至26.0±6.2%（P<0.05），而肺血管阻力指数无任何变化。我们得出结论，在单肺通气期间，多巴酚丁胺比多巴胺和硝酸甘油更具优势。
