Hilton J G, McPherson M B, Marullo D S
Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston.
Burns Incl Therm Inj. 1987 Dec;13(6):454-7. doi: 10.1016/0305-4179(87)90222-1.
It has been suggested that post-burn myocardial depression may be due to coronary constriction which results in myocardial ischaemia. It has been demonstrated that the levels of vasopressin, a potent natural constrictor of blood vessels, increase four- to six-fold immediately after thermal trauma. Therefore, this substance could be responsible for post-burn coronary constriction and myocardial depression. This was tested using the dog anaesthetized with sodium pentobarbital receiving a 15 per cent total body surface area full thickness flame burn as the experimental model. Cardiac output was measured by the thermal dilution technique. Arterial blood pressure was sensed by a Stathem P-23 transducer. Cardiac force of contraction was measured by a Walton-Brody strain gauge arch sewn on the left ventricle. The results of this study showed a significant decrease in cardiac output, increase in peripheral resistance and decrease in myocardial force of contraction immediately after thermal trauma in untreated animals. The decrease in cardiac output and increase in peripheral resistance remained for the duration of the experimental observations (3 h). The decrease in force of contraction returned to pre-burn levels 1 h post-burn. Pretreatment of the experimental animals with d(CH2)5 Tyr(Me)AVP (SK&F 100273), a vasopressin V-1 receptor blocking agent, prevented the initial decrease in cardiac output, increase in peripheral resistance and decrease in the force of contraction. A correlation plot of peripheral resistance vs. cardiac force of contraction showed a positive correlation between these two variables in the pretreated animals.(ABSTRACT TRUNCATED AT 250 WORDS)
有人提出,烧伤后心肌抑制可能是由于冠状动脉收缩导致心肌缺血所致。已经证明,血管加压素(一种强大的天然血管收缩剂)的水平在热损伤后立即增加四到六倍。因此,这种物质可能是烧伤后冠状动脉收缩和心肌抑制的原因。本研究以戊巴比妥钠麻醉、全身表面积15%的全层火焰烧伤的犬作为实验模型进行验证。心输出量采用热稀释技术测量。动脉血压由Stathem P-23传感器感应。心肌收缩力通过缝在左心室的Walton-Brody应变仪弓进行测量。这项研究的结果表明,在未治疗的动物中,热损伤后立即出现心输出量显著下降、外周阻力增加和心肌收缩力下降。心输出量的下降和外周阻力的增加在实验观察期间(3小时)一直存在。收缩力的下降在烧伤后1小时恢复到烧伤前水平。用血管加压素V-1受体阻断剂d(CH2)5 Tyr(Me)AVP(SK&F 100273)对实验动物进行预处理,可防止心输出量最初的下降、外周阻力的增加和收缩力的下降。外周阻力与心肌收缩力的相关图显示,在预处理的动物中,这两个变量之间呈正相关。(摘要截短于250字)