Sigurdsson G H, Christenson J T
Department of Surgery, Faculty of Medicine, Kuwait University, Safat.
Circ Shock. 1988 Jul;25(3):153-63.
The effects of the beta-2-receptor agonist terbutaline on central hemodynamics, gas exchange, and platelet and leukocyte counts during 3 hr of endotoxin shock were studied. Ten sheep were anesthetized and ventilated without positive end-expiratory pressure (PEEP). After 1 hr of stabilization (t = -30), five animals (Group T) received intravenous (i.v.) infusion of terbutaline, 20 micrograms/kg/hr for 3.5 hr, whereas the other five received no drug treatment and served as controls (Group C). Thirty min later (t = 0) all animals received Escherichia coli endotoxin 10 micrograms/kg by i.v. infusion over 15 min. The terbutaline infusion increased the heart rate (HR) initially by 30% and the cardiac index (CI) by 50%, whereas mean arterial pressure (MAP), pulmonary artery pressure (PAP), and gas exchange remained unchanged. Terbutaline pretreatment did not prevent the pulmonary hypertension that characteristically occurs after endotoxin injection, nor did it decrease the initial fall in platelet count, leukocyte count, arterial oxygen tension (PaO2), or respiratory compliance (t = 30). However, during the permeability phase (after 120-180 min), there was a significant improvement in MAP, PAP, respiratory compliance, PaO2, and arterial pH in the animals treated with terbutaline as compared with the control animals. Also, the wet weight to dry weight ratio of the lungs from animals receiving terbutaline was significantly lower than in controls. It was concluded that terbutaline does not influence the hypertension phase during endotoxin shock, but it may decrease pulmonary microvascular leakage during the permeability phase.
研究了β2受体激动剂特布他林对内毒素休克3小时期间中心血流动力学、气体交换以及血小板和白细胞计数的影响。十只绵羊在无呼气末正压（PEEP）的情况下进行麻醉和通气。在稳定1小时（t = -30）后，五只动物（T组）接受静脉输注特布他林，剂量为20微克/千克/小时，持续3.5小时，而另外五只未接受药物治疗作为对照（C组）。30分钟后（t = 0），所有动物通过静脉输注在15分钟内给予10微克/千克的大肠杆菌内毒素。特布他林输注最初使心率（HR）增加30%，心脏指数（CI）增加50%，而平均动脉压（MAP）、肺动脉压（PAP）和气体交换保持不变。特布他林预处理并未预防内毒素注射后典型出现的肺动脉高压，也未减少血小板计数、白细胞计数、动脉血氧张力（PaO2）或呼吸顺应性的初始下降（t = 30）。然而，在通透性阶段（120 - 180分钟后），与对照动物相比，接受特布他林治疗的动物在MAP、PAP、呼吸顺应性、PaO2和动脉pH方面有显著改善。此外，接受特布他林的动物肺组织湿重与干重之比明显低于对照组。得出的结论是，特布他林在内毒素休克期间不影响高血压阶段，但可能在通透性阶段减少肺微血管渗漏。
