Knapp Jürgen, Teschendorf Peter, Scholz Eberhard, Roewer Joachim, Russ Nicolai, Böttiger Bernd W, Popp Erik
Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.
Department of Anaesthesiology and Postoperative Intensive Care Medicine, Clinical Center of Osnabrück, Osnabrück, Germany.
J Am Assoc Lab Anim Sci. 2014 Jul;53(4):392-8.
We demonstrate the usefulness of left ventricular pressure-volume (PV) loops generated by the use of conductance catheter measurements and investigate the influence of the type of general anesthesia on postresuscitation myocardial dysfunction in a rat model of cardiac arrest (CA) and subsequent cardiopulmonary resuscitation. A total of 42 Wistar-Han rats were randomized to receive general anesthesia with sevoflurane and resuscitation after CA, general anesthesia with pentobarbital intraperitoneally and resuscitation after CA, or general anesthesia with pentobarbital without CA (sham group). Myocardial function, assessed by analysis of PV loops, was measured continuously and in real-time by using a PV-conductance catheter. Rats were monitored for 3 h after restoration of spontaneous circulation (ROSC). The use of PV-conductance catheters supported objective and reliable evaluation of myocardial function and proved feasible in this rat model of CA. End-diastolic volume increased in rats anesthetized with pentobarbital after ROSC (before CA, 237 ± 45 μL; after ROSC, 402 ± 64 μL). Preloadadjusted maximal power before CA was the same in all groups but decreased in both resuscitated groups. The decrease was less pronounced in rats anesthetized with sevoflurane compared with pentobarbital (11.8 ± 4.9 mW/μL(2) compared with 4.8 ± 1.9 mW/μL(2) at 3 h after ROSC). This finding indicates that the type of general anesthesia influences postresuscitation myocardial dysfunction in this rat model of experimentally induced CA and cardiopulmonary resuscitation. Rats that were anesthetized with sevoflurane exhibited less postresuscitation myocardial dysfunction than did those anesthetized with pentobarbital.
我们展示了通过使用电导导管测量生成的左心室压力-容积(PV)环的实用性,并在大鼠心脏骤停(CA)及随后的心肺复苏模型中,研究了全身麻醉类型对复苏后心肌功能障碍的影响。总共42只Wistar-Han大鼠被随机分为三组,分别接受七氟醚全身麻醉并在CA后进行复苏、腹腔注射戊巴比妥全身麻醉并在CA后进行复苏,或接受戊巴比妥全身麻醉但无CA(假手术组)。通过PV环分析评估的心肌功能,使用PV-电导导管进行连续实时测量。在自主循环恢复(ROSC)后对大鼠监测3小时。PV-电导导管的使用支持了对心肌功能的客观可靠评估,并在该大鼠CA模型中证明是可行的。ROSC后,接受戊巴比妥麻醉的大鼠舒张末期容积增加(CA前,237±45μL;ROSC后,402±64μL)。所有组在CA前的预负荷调整最大功率相同,但两个复苏组均降低。与戊巴比妥相比,七氟醚麻醉的大鼠中这种降低不太明显(ROSC后3小时,分别为11.8±4.9mW/μL²和4.8±1.9mW/μL²)。这一发现表明,全身麻醉类型影响了该实验性诱导的CA和心肺复苏大鼠模型中的复苏后心肌功能障碍。与接受戊巴比妥麻醉的大鼠相比,接受七氟醚麻醉的大鼠复苏后心肌功能障碍较轻。