Clinic of Anaesthesiology and Intensive Care, AHEPA University Hospital, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 540 06, Thessaloniki, Greece.
Department of Clinical Pharmacology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece.
Naunyn Schmiedebergs Arch Pharmacol. 2020 Jan;393(1):89-97. doi: 10.1007/s00210-019-01713-3. Epub 2019 Aug 17.
We designed this experimental study with a view to evaluate the effects of dexmedetomidine (DEX) on cardiac performance and systemic and peripheral hemodynamics in healthy and early-stage endotoxemia swine models. Our study hypothesis was that DEX can ensure hemodynamic stability during the course of endotoxemia. Thirty-two male pigs (25-27 kg) were assigned into four groups: (1) no intervention (group A), (2) DEX 0.8 μg/kg was administered in non-septic animals (group B), (3) sepsis induced by intravenous Escherichia coli endotoxin (group C) and (4) DEX 0.8 μg/kg was administered in septic animals (group D). Hemodynamic parameters such as heart rate, mean blood pressure, central venous pressure, pulmonary artery pressures, pulmonary artery occlusion pressure, pulmonary vascular resistance and cardiac output were continuously recorded. Central venous oxygen saturation was also measured in order to obtain a complete evaluation of cardiovascular response to sepsis. Heart rate was decreased, whilst mean arterial pressure decrease was alleviated after DEX administration in septic animals. In addition, central venous pressure was stable in animals with sepsis after DEX infusion. Sepsis dramatically elevated pulmonary function indicators but DEX succeeded in ameliorating this effect. The important decrease measured in central venous oxygen saturation in both sepsis groups reflected the decreased perfusion of tissues that takes place at the end of early sepsis. Our findings support the hypothesis that DEX has beneficial effects on heart rate and pulmonary artery pressure, whilst reduction in systemic blood pressure occurs at acceptable levels.
我们设计了这项实验研究，旨在评估右美托咪定（DEX）对健康和早期内毒素血症猪模型心脏功能以及全身和外周血液动力学的影响。我们的研究假设是 DEX 可以在内毒素血症期间确保血液动力学稳定。32 只雄性猪（25-27kg）被分为四组：（1）无干预（A 组），（2）非脓毒症动物给予 DEX 0.8μg/kg（B 组），（3）静脉注射大肠杆菌内毒素引起的脓毒症（C 组），和（4）在脓毒症动物中给予 DEX 0.8μg/kg（D 组）。连续记录心率、平均血压、中心静脉压、肺动脉压、肺动脉闭塞压、肺血管阻力和心输出量等血液动力学参数。还测量了中心静脉血氧饱和度，以便对内毒素血症对心血管反应进行全面评估。在脓毒症动物中给予 DEX 后，心率降低，平均动脉压降低得到缓解。此外，在 DEX 输注后，脓毒症动物的中心静脉压保持稳定。脓毒症显著升高了肺功能指标，但 DEX 成功地改善了这一效应。在两组脓毒症中，中心静脉血氧饱和度的重要降低反映了在早期脓毒症结束时组织灌注减少。我们的研究结果支持 DEX 对心率和肺动脉压有有益影响的假设，同时全身血压的降低保持在可接受的水平。
