Ishizuka Tomohito, Tamura Jun, Nagaro Tsukasa, Sudo Kanako, Itami Takaharu, Umar Mohammed Ahamed, Miyoshi Kenjirou, Sano Tadashi, Yamashita Kazuto
Departments of Small Animal Clinical Sciences School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan.
J Vet Med Sci. 2014 Dec;76(12):1577-82. doi: 10.1292/jvms.14-0077. Epub 2014 Sep 3.
Effects of intermittent positive pressure ventilation (IPPV) on cardiopulmonary function were evaluated in horses anesthetized with total intravenous anesthesia using constant rate infusions of medetomidine (3.5 µg/kg/hr), lidocaine (3 mg/kg/hr), butorphanol (24 µg/kg/hr) and propofol (0.1 mg/kg/min) (MLBP-TIVA). Five horses were anesthetized twice using MLBP-TIVA with or without IPPV at 4-week interval (crossover study). In each occasion, the horses breathed 100% oxygen with spontaneous ventilation (SB-group, n=5) or with IPPV (CV-group, n=5), and changes in cardiopulmonary parameters were observed for 120 min. In the SB-group, cardiovascular parameters were maintained within acceptable ranges (heart rate: 33-35 beats/min, cardiac output: 27-30 l/min, mean arterial blood pressure [MABP]: 114-123 mmHg, mean pulmonary arterial pressure [MPAP]: 28-29 mmHg and mean right atrial pressure [MRAP]: 19-21 mmHg), but severe hypercapnea and insufficient oxygenation were observed (arterial CO(2) pressure [PaCO(2)]: 84-103 mmHg and arterial O(2) pressure [PaO(2)]: 155-172 mmHg). In the CV-group, normocapnea (PaCO(2): 42-50 mmHg) and good oxygenation (PaO(2): 395-419 mmHg) were achieved by the IPPV without apparent cardiovascular depression (heart rate: 29-31 beats/min, cardiac output: 17-21 l /min, MABP: 111-123 mmHg, MPAP: 27-30 mmHg and MRAP: 15-16 mmHg). MLBP-TIVA preserved cardiovascular function even in horses artificially ventilated.
在使用美托咪定(3.5微克/千克/小时)、利多卡因(3毫克/千克/小时)、布托啡诺(24微克/千克/小时)和丙泊酚(0.1毫克/千克/分钟)持续静脉输注进行全静脉麻醉(MLBP - TIVA)的马匹中,评估了间歇正压通气(IPPV)对心肺功能的影响。五匹马每隔4周使用MLBP - TIVA进行两次麻醉,一次无IPPV,一次有IPPV(交叉研究)。在每种情况下,马匹通过自主通气呼吸100%氧气(SB组,n = 5)或通过IPPV呼吸(CV组,n = 5),并观察120分钟内心肺参数的变化。在SB组中,心血管参数维持在可接受范围内(心率:33 - 35次/分钟,心输出量:27 - 30升/分钟,平均动脉血压[MABP]:114 - 123毫米汞柱,平均肺动脉压[MPAP]:28 - 29毫米汞柱,平均右心房压[MRAP]:19 - 21毫米汞柱),但观察到严重的高碳酸血症和氧合不足(动脉二氧化碳分压[PaCO₂]:84 - 103毫米汞柱,动脉氧分压[PaO₂]:155 - 172毫米汞柱)。在CV组中,通过IPPV实现了正常碳酸血症(PaCO₂:42 - 50毫米汞柱)和良好的氧合(PaO₂:395 - 419毫米汞柱),且无明显的心血管抑制(心率:29 - 31次/分钟,心输出量:17 - 21升/分钟,MABP:111 - 123毫米汞柱,MPAP:27 - 30毫米汞柱,MRAP:15 - 16毫米汞柱)。即使在人工通气的马匹中,MLBP - TIVA也能维持心血管功能。