Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-70185, Örebro, Sweden.
Department of Vascular Surgery and Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital and Academy, Gothenburg, Sweden.
J Cardiovasc Transl Res. 2019 Jun;12(3):240-249. doi: 10.1007/s12265-018-9845-6. Epub 2018 Nov 19.
The impact of acute cardiac dysfunction on the gastrointestinal tract was investigated in anesthetized and instrumented pigs by sequential reductions of cardiac output (CO). Using a cardiac tamponade (n = 6) or partial inferior caval vein balloon inflation (n = 6), CO was controllably reduced for 1 h each to 75% (CO), 50% (CO), and 35% (CO) of the baseline value. Cardiac output in controls (n = 6) was not manipulated and maintained. Mean arterial pressure, superior mesenteric arterial blood flow, and intestinal mucosal perfusion started to decrease at CO in the intervention groups. The decrease in superior mesenteric arterial blood flow was non-linear and exaggerated at CO. Systemic, venous mesenteric, and intraperitoneal lactate concentrations increased in the intervention groups from CO. Global and mesenteric oxygen uptake decreased at CO. In conclusion, gastrointestinal metabolism became increasingly anaerobic when CO was reduced by 50%. Anaerobic gastrointestinal metabolism in low CO can be detected using intraperitoneal microdialysis.
本研究旨在通过逐步降低心输出量(CO),在麻醉和仪器猪中研究急性心功能障碍对胃肠道的影响。使用心脏填塞(n=6)或部分下腔静脉球囊充气(n=6),将 CO 分别可控地降低至基线值的 75%(CO)、50%(CO)和 35%(CO),持续 1 小时。对照组(n=6)的 CO 未受影响且保持不变。在干预组中,CO 时平均动脉压、肠系膜上动脉血流和肠黏膜灌注开始下降。肠系膜上动脉血流的减少是非线性的,在 CO 时加剧。从 CO 开始,干预组的全身、静脉肠系膜和腹腔内乳酸浓度增加。CO 时,全身和肠系膜氧摄取减少。总之,当 CO 降低 50%时,胃肠道代谢变得越来越无氧。通过腹腔内微透析可以检测到低 CO 时的无氧胃肠道代谢。