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去传入神经犬诱导性低血压期间血流分布和血管容量的改变

Alteration of blood flow distribution and vascular capacitance during induced hypotension in deafferented dogs.

作者信息

Hoka S, Siker D, Bosnjak Z J, Kampine J P

出版信息

Anesthesiology. 1987 May;66(5):647-52. doi: 10.1097/00000542-198705000-00009.

Abstract

The effects of three hypotensive agents, sodium nitroprusside (SNP), nitroglycerin (NTG), and adenosine triphosphate (ATP), on blood flow distribution and vascular capacitance were examined in dogs anesthetized with sodium pentobarbital. To eliminate the modification by the baroreflex, carotid sinus was denervated and aortic and cardiopulmonary vagal fibers were sectioned. Total systemic circulation was divided into two parallel compartments, splanchnic (SP) and extra-splanchnic (ESP) vascular beds. Alteration of vascular capacitance was assessed by a change in systemic blood volume with constant cardiac output and constant venous pressure using a total heart-lung bypass. SNP- and ATP-induced hypotension caused blood flow redistribution from the SP to ESP beds, and this redistribution is greater (P less than 0.01) with ATP than that with SNP. In contrast, NTG-induced hypotension did not significantly cause redistribution. Systemic blood volume was increased during NTG- (10.4 +/- 2.2 ml/kg), and SNP-induced (4.8 +/- 1.1 ml/kg) hypotension. The increase by NTG was significantly greater (P less than 0.05) than that by SNP. In contrast, ATP-induced hypotension did not significantly change systemic blood volume. Since redistribution can result in a passive change in vascular capacitance, the differences in capacitance among SNP, NTG, and ATP can be explained in part by differences in redistribution of blood flow. Redistribution of blood flow from SP to ESP beds can increase venous return due to increasing the slope of the venous return curve. The results suggest that redistribution should be taken into consideration in evaluating the hemodynamic changes during induced hypotension.

摘要

在戊巴比妥钠麻醉的犬中,研究了三种降压药硝普钠(SNP)、硝酸甘油(NTG)和三磷酸腺苷(ATP)对血流分布和血管容量的影响。为消除压力感受器反射的影响,切断了颈动脉窦神经,并切断了主动脉和心肺迷走神经纤维。将体循环分为两个平行部分,即内脏(SP)和内脏外(ESP)血管床。使用全心肺旁路,在心脏输出量和静脉压力恒定的情况下,通过全身血容量的变化来评估血管容量的改变。SNP和ATP诱导的低血压导致血流从SP床重新分布到ESP床,且ATP引起的这种重新分布比SNP更显著(P<0.01)。相比之下,NTG诱导的低血压并未显著引起血流重新分布。NTG诱导的低血压(10.4±2.2 ml/kg)和SNP诱导的低血压(4.8±1.1 ml/kg)期间,全身血容量增加。NTG引起的增加比SNP显著更大(P<0.05)。相比之下,ATP诱导的低血压并未显著改变全身血容量。由于血流重新分布可导致血管容量的被动变化,SNP、NTG和ATP之间血管容量的差异可部分由血流重新分布的差异来解释。血流从SP床重新分布到ESP床可通过增加静脉回流曲线的斜率来增加静脉回流。结果表明,在评估诱导性低血压期间的血流动力学变化时应考虑血流重新分布。

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