Miller Douglas L, Dou Chunyan, Raghavendran Krishnan
Departments of Radiology (D.L.M., C.D.) and Surgery (K.R.), University of Michigan Health System, Ann Arbor, Michigan USA.
J Ultrasound Med. 2015 Feb;34(2):289-97. doi: 10.7863/ultra.34.2.289.
Pulmonary capillary hemorrhage can be induced by diagnostic ultrasound (US) during direct pulmonary US scanning in rats. The influence of specific anesthetic techniques on this bioeffect was examined.
Ketamine plus xylazine has been used previously. In this study, the influence of intraperitoneal injections of ketamine and pentobarbital, inhalational isoflurane, and the supplemental use of xylazine with ketamine and isoflurane was tested. A diagnostic US machine with a 7.6-MHz linear array was used to image the right lung of anesthetized rats in a warmed water bath at different mechanical index (MI) settings. Pulmonary capillary hemorrhage was assessed by measuring comet tail artifacts in the image and by morphometry of the hemorrhagic areas on excised lungs.
Pulmonary capillary hemorrhage was greatest for pentobarbital, lower for inhalational isoflurane, and lowest for ketamine anesthesia, with occurrence thresholds at MIs of about 0.44, 0.8, and 0.8, respectively. Addition of xylazine produced a substantial increase in hemorrhage and a significant proportion of hemorrhage occurrence for ketamine at an MI of 0.7 (P < .01) and for isoflurane at an MI of 0.52 (P < .01).
Ketamine plus xylazine and pentobarbital yield lower thresholds than ketamine or isoflurane alone by nearly a factor of 2 in MI. These results suggest that the choice of the anesthetic agent substantially modifies the relative risks of pulmonary capillary hemorrhage from pulmonary US.
在对大鼠进行直接肺部超声扫描时,诊断性超声(US)可诱发肺毛细血管出血。本研究检测了特定麻醉技术对这种生物效应的影响。
氯胺酮加赛拉嗪此前已被使用。在本研究中,测试了腹腔注射氯胺酮和戊巴比妥、吸入异氟烷,以及氯胺酮和异氟烷联合使用赛拉嗪的影响。使用一台配备7.6兆赫线性阵列的诊断超声仪,在温水浴中对麻醉大鼠的右肺进行成像,设置不同的机械指数(MI)。通过测量图像中的彗尾伪像以及对切除肺脏上出血区域进行形态计量学分析来评估肺毛细血管出血情况。
戊巴比妥麻醉时肺毛细血管出血最为严重,吸入异氟烷时出血较轻,氯胺酮麻醉时出血最少,出血发生阈值的MI分别约为0.44、0.8和0.8。添加赛拉嗪后,在MI为0.7时氯胺酮组出血大幅增加且出血发生率显著升高(P <.01),在MI为0.52时异氟烷组出血也显著增加(P <.01)。
氯胺酮加赛拉嗪和戊巴比妥产生的阈值比单独使用氯胺酮或异氟烷时低近2倍。这些结果表明,麻醉剂的选择会显著改变肺部超声导致肺毛细血管出血的相对风险。