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[二氧化碳(低碳酸血症和高碳酸血症)对犬肝脏、肾脏和骨骼肌组织血流及氧合的影响]

[Effects of carbon dioxide (hypocapnia and hypercapnia) on tissue blood flow and oxygenation of liver, kidney and skeletal muscle in the dog].

作者信息

Okazaki K, Okutsu Y, Fukunaga A

出版信息

Masui. 1989 Apr;38(4):457-64.

PMID:2498552
Abstract

UNLABELLED

We investigated the effects of carbon dioxide on the splanchnic visceral organs (liver and kidney) as well as skeletal muscle in the anesthetized dog. Thirty two adult mongrel dogs were anesthetized with sodium pentobarbital, intubated and ventilated mechanically with 100% oxygen to maintain normocapnia. After laparotomy, miniature Clark-type polarographic oxygen electrodes were placed on the surfaces of liver, kidney and rectus femoris muscle. Electromagnetic blood flow (BF) probes were also applied to hepatic artery (HA), portal vein (PV), left renal artery (RA) and left femoral artery (FA). After a stable normocapnic ventilation, the hypocapnia was produced by increasing respiratory rate, and the hypercapnia was induced by adding the exogenous carbon dioxide.

RESULTS

Hyperventilation resulted in a significant decrease in HABF, PVBF, liver surface PO2 and kidney surface PO2 in parallel with the decreased PaCO2, but these parameters increased dose dependently when the carbon dioxide was added to the inspired gas (hypercapnic hyperventilation). On the contrary, FABF and skeletal muscle surface PO2 increased by hypocapnia and decreased during hypercapnia. Neither PaCO2 or cardiac output showed any significant change during the entire experiment. Arterial PCO2 appears to exert significant effects on both splanchnic and skeletal muscle perfusion as well as corresponding changes in tissue oxygenations. It is possible that injudicious and prolonged hypocapnic hyperventilation may seriously compromise splanchnic organ perfusion and oxygenation.

摘要

未标注

我们研究了二氧化碳对麻醉犬内脏器官(肝脏和肾脏)以及骨骼肌的影响。32只成年杂种犬用戊巴比妥钠麻醉,插管并机械通气,吸入100%氧气以维持正常碳酸血症。剖腹术后,将微型克拉克型极谱氧电极置于肝脏、肾脏和股直肌表面。电磁血流(BF)探头也应用于肝动脉(HA)、门静脉(PV)、左肾动脉(RA)和左股动脉(FA)。在稳定的正常碳酸血症通气后,通过增加呼吸频率产生低碳酸血症,通过添加外源性二氧化碳诱导高碳酸血症。

结果

过度通气导致肝动脉血流(HABF)、门静脉血流(PVBF)、肝脏表面氧分压(PO2)和肾脏表面PO2显著降低,同时伴有动脉血二氧化碳分压(PaCO2)降低,但当向吸入气体中添加二氧化碳(高碳酸血症性过度通气)时,这些参数呈剂量依赖性增加。相反,股动脉血流(FABF)和骨骼肌表面PO2在低碳酸血症时增加,在高碳酸血症时降低。在整个实验过程中,PaCO2和心输出量均未显示任何显著变化。动脉血PCO2似乎对内脏和骨骼肌灌注以及组织氧合的相应变化均有显著影响。不恰当和长时间的低碳酸血症性过度通气可能会严重损害内脏器官灌注和氧合。

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