Schiffner René, Lehmann Thomas, Bischoff Sabine J, Zippelius Timo, Nistor Marius, Schmidt Martin
Department of Orthopaedics, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Clin Hemorheol Microcirc. 2018;70(3):311-325. doi: 10.3233/CH-180382.
Previous studies on the recombinant form of human relaxin-2 (serelaxin) have shown a decrease of pulmonary hemodynamics after serelaxin injection. Currently, the effect of serelaxin treatment during hypovolemia in a large animal model remains mostly unknown.
12 sheep were randomly assigned to a sham or serelaxin (30μg/kg serelaxin) group and underwent right heart catheterization. 50% of the estimated total blood volume were removed to induce hypovolemia, and subsequently retransfused 20 min later (reinfusion). Blood gases, heart rate, peripheral and pulmonary arterial oxygen saturation, systolic, diastolic and mean values of both pulmonary artery pressure (PAP) and pulmonary capillary wedge pressure (PCW) were measured. Cardiac output (CO), pulmonary vascular resistance (PVR), pulmonary arterial compliance (PAcompl) and systemic vascular resistance (SVR) were calculated.
Hypovolemia and shock led to a similar decrease of PAP and PCW in both groups (p≤0.001). CO, SV and PAcompl decreased only in the control group (p≤0.05) and remained higher in the serelaxin-treated group. The results of this study suggest that serelaxin treatment did not negatively influence hemodynamic parameters during hypovolemic shock.
The main conclusion of this study is that cardiopulmonary adaption mechanisms are not critically altered by serelaxin administration during severe hypovolemia and retransfusion.
先前关于重组人松弛素-2(serelaxin)的研究表明,注射serelaxin后肺血流动力学有所下降。目前,在大型动物模型中低血容量状态下serelaxin治疗的效果大多仍不清楚。
将12只绵羊随机分为假手术组或serelaxin组(30μg/kg serelaxin),并进行右心导管插入术。去除估计总血容量的50%以诱导低血容量,随后在20分钟后重新输血(再灌注)。测量血气、心率、外周和肺动脉血氧饱和度、肺动脉压(PAP)和肺毛细血管楔压(PCW)的收缩压、舒张压和平均值。计算心输出量(CO)、肺血管阻力(PVR)、肺动脉顺应性(PAcompl)和体循环血管阻力(SVR)。
低血容量和休克导致两组PAP和PCW均出现类似程度的下降(p≤0.001)。CO、SV和PAcompl仅在对照组中下降(p≤0.05),而在接受serelaxin治疗的组中仍较高。本研究结果表明,serelaxin治疗在低血容量性休克期间对血流动力学参数没有负面影响。
本研究的主要结论是,在严重低血容量和再输血期间,给予serelaxin不会严重改变心肺适应机制。