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猪主动脉根部钾离子浓度受氯化钾中心静脉与外周静脉团注给药影响的比较。

A comparison of the effects of central v peripheral bolus injections of potassium chloride on aortic root potassium concentrations in swine.

作者信息

Scheller M S, Mazzei W J, Zornow M H, Mitchell M M

机构信息

Department of Anesthesiology, University of California, San Diego School of Medicine 92103.

出版信息

J Cardiothorac Anesth. 1989 Apr;3(2):172-5. doi: 10.1016/s0888-6296(89)92546-5.

Abstract

Clinically relevant doses of potassium chloride (equivalent to 2 mEq/60 kg of body weight) were administered as rapid intravenous (IV) boluses to healthy halothane-anesthetized pigs. Potassium was given either peripherally through a standard IV ear catheter or centrally through the central venous port of a pulmonary artery catheter. Multiple injections were made in each pig, and cardiac output was varied by changing end-tidal halothane concentration. The aortic root potassium concentration was measured every three to six seconds for 90 seconds following potassium administration in each pig. Monitored variables included end-tidal halothane, end-tidal carbon dioxide, pulmonary artery pressure, mean arterial blood pressure, cardiac output, electrocardiogram, and temperature. Following both peripheral and central administration of potassium chloride, aortic root potassium increased significantly. However, the time required to achieve the peak aortic root potassium concentration was significantly less after central administration. In addition, the change in aortic root potassium concentration was greater following central administration compared with peripheral. The change in aortic root potassium concentration correlated inversely with cardiac output only after central, but not peripheral injection. Despite marked transient hyperkalemia in all animals, no electrocardiographic evidence of hyperkalemia could be demonstrated. It is concluded that small bolus doses of potassium chloride (2 mEq/60 kg) can be given safely either peripherally or centrally in normal, hemodynamically stable swine.

摘要

将临床相关剂量的氯化钾(相当于2毫当量/60千克体重)以快速静脉推注的方式给予健康的氟烷麻醉猪。钾通过标准的静脉耳部导管外周给药,或通过肺动脉导管的中心静脉端口中心给药。对每头猪进行多次注射,并通过改变呼气末氟烷浓度来改变心输出量。在每头猪给药后90秒内,每隔三到六秒测量一次主动脉根部钾浓度。监测变量包括呼气末氟烷、呼气末二氧化碳、肺动脉压、平均动脉血压、心输出量、心电图和体温。外周和中心给予氯化钾后,主动脉根部钾均显著升高。然而,中心给药后达到主动脉根部钾浓度峰值所需的时间明显更短。此外,与外周给药相比,中心给药后主动脉根部钾浓度的变化更大。仅在中心注射后,而不是外周注射后,主动脉根部钾浓度的变化与心输出量呈负相关。尽管所有动物均出现明显的短暂高钾血症,但未发现高钾血症的心电图证据。得出的结论是,在正常、血流动力学稳定的猪中,小剂量推注氯化钾(2毫当量/60千克)无论是外周给药还是中心给药都是安全的。

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