Binhas M, Deleuze P, Videcoq M, Kawasaki K, Loisance D
Département d'anesthésie-réanimation n. II, CHU Henri-Mondor, Créteil.
Arch Mal Coeur Vaiss. 1989 Apr;82(4):601-5.
The haemodynamic effect of any drug being the resultant of its myocardial and vascular actions, it is often difficult to separate what is due to each of these components. Dobutamine is regarded as having an almost exclusive effect on the myocardium in therapeutic doses (1); its administration after implantation of an artificial heart would enable its peripheral vascular effects to be determined by exclusion of the native ventricles. Experiments were conducted on three calves weighing about 90 kg each. The artificial heart, two central venous catheters and a femoral arterial catheter were implanted under general anaesthesia. The study began on the first post-implantation day, the animals being awake, in stable haemodynamic status and with normal temperature. Dobutamine was infused through one of the venous catheter placed in the native atrium, in 6 stepwise doses of 5, 10, 15, 20, 25 and 30 mcg/kg/min, each dose being given over 10 min and separated from the other dose by a 10 min interval. The order in which these doses were administered was determined at random. By adjusting the propulsion pressure of the two ventricles and the heart rate, the cardiac output was set at a fixed value of 7.85 L/min throughout the study, this value being controlled by a computer-assisted unit. Right atrial pressure and femoral arterial were recorded during each step of the infusion. Total peripheral resistance was calculated over a stable period of the last 5 min of each dosing and before administration of dobutamine. This procedure was repeated 4 times in each calf, at intervals of 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
任何药物的血流动力学效应都是其心肌作用和血管作用的综合结果,因此往往难以区分这两种作用各自的贡献。多巴酚丁胺在治疗剂量下被认为几乎只对心肌有作用(1);在植入人工心脏后给予多巴酚丁胺,可以通过排除天然心室来确定其外周血管效应。对三头体重约90公斤的小牛进行了实验。在全身麻醉下植入人工心脏、两根中心静脉导管和一根股动脉导管。研究在植入后的第一天开始,动物处于清醒状态,血流动力学状态稳定,体温正常。多巴酚丁胺通过置于天然心房的一根静脉导管输注,分6个逐步递增剂量,分别为5、10、15、20、25和30微克/千克/分钟,每个剂量持续输注10分钟,相邻剂量之间间隔10分钟。这些剂量的给药顺序是随机确定的。通过调节两个心室的推进压力和心率,在整个研究过程中将心输出量设定为固定值7.85升/分钟,该值由计算机辅助装置控制。在每次输注步骤中记录右心房压力和股动脉压力。在每个给药期最后5分钟的稳定期以及给予多巴酚丁胺之前计算总外周阻力。每头小牛按此程序重复4次,间隔24小时。(摘要截选至250字)