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失血性低血压及去氧肾上腺素治疗期间的经皮和肝表面氧分压

Transcutaneous and liver surface PO2 during hemorrhagic hypotension and treatment with phenylephrine.

作者信息

Tremper K K, Barker S J, Hufstedler S M, Weiss M

机构信息

Department of Anesthesiology, University of California, Irvine, Medical Center, Orange 92668.

出版信息

Crit Care Med. 1989 Jun;17(6):537-40. doi: 10.1097/00003246-198906000-00011.

Abstract

Transcutaneous PO2 (PtcO2) and liver surface PO2 (PIO2) were measured in six mongrel dogs during hemorrhagic shock, normotensive shock, and volume resuscitation. Normotension was produced during extreme hypovolemia by an infusion of phenylephrine. PtcO2 and PlO2 were compared to each other and to hemodynamic and oxygen transport variables. PtcO2 and PlO2 correlated well with cardiac index (CI) r = .71 and .86, respectively; n = 60) and with each other (r = .79; n = 60). Heart rate, mean arterial pressure (MAP), and PaO2) correlated less with PtcO2 or PlO2. During the normotensive shock period, PtcO2, PIO2, CI, oxygen delivery (DO2), and oxygen consumption (VO2) were all severely decreased, while PaO2 and MAP were normal and lactic acid concentrations were elevated. It was concluded that PtcO2 follows changes in PlO2 during hypotensive and normotensive low cardiac output shock in mongrel dogs. Low PtcO2 values are associated with low values of PlO2, DO2, VO2, and rising lactic acid concentrations in dogs. These animal data imply that low PtcO2 values encountered in clinical monitoring during anesthesia and surgery may correspond to decreased blood volume, blood flow, and PlO2.

摘要

在六只杂种犬身上测量了失血性休克、正常血压休克和容量复苏期间的经皮氧分压(PtcO2)和肝表面氧分压(PIO2)。通过输注去氧肾上腺素在极度低血容量时维持正常血压。将PtcO2和PlO2相互比较,并与血流动力学和氧输送变量进行比较。PtcO2和PlO2与心脏指数(CI)分别具有良好的相关性(r = 0.71和0.86;n = 60),且二者之间也具有相关性(r = 0.79;n = 60)。心率、平均动脉压(MAP)和动脉血氧分压(PaO2)与PtcO2或PlO2的相关性较小。在正常血压休克期间,PtcO2、PIO2、CI、氧输送(DO2)和氧消耗(VO2)均显著降低,而PaO2和MAP正常,乳酸浓度升高。得出的结论是,在杂种犬的低血压和正常血压低心输出量休克期间,PtcO2随PlO2的变化而变化。犬的低PtcO2值与低PlO2值、DO2、VO2以及乳酸浓度升高相关。这些动物实验数据表明,麻醉和手术期间临床监测中遇到的低PtcO2值可能与血容量、血流量和PlO2降低相对应。

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