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麻醉山羊心脏骤停导致的心肌氧耗降低率

Rate of decrease of myocardial O2 consumption due to cardiac arrest in anesthetized goats.

作者信息

Vergroesen I, Spaan J A

机构信息

Department of Medical Physics, AMC, Amsterdam, The Netherlands.

出版信息

Pflugers Arch. 1988 Dec;413(2):160-6. doi: 10.1007/BF00582526.

Abstract

The rate of change of myocardial O2 consumption, MVO2, has been measured during the transition from beating to cardiac arrest. Cardiac arrest was achieved by destruction of the bundle of His by injection of formalin and induced by 25 s interruption of pacing. The left main coronary artery was perfused under constant pressure and the great cardiac vein was drained under controlled pressure. The arterio-venous O2 content difference, O2, and coronary arterial and venous flows, CAF resp CVF, were continuously measured. The MVO2 transient was calculated using the following equation based on a 3 compartment model: MVO2 = CAF . O2 - (Vc + Vv) . d[O2]v/dt - (Vc . Vv/CVF) . d2[O2]v/dt2 where Vc and Vv are the capillary and the venous blood volume as function of time and [O2]v is the venous oxygen content. A 7th order polynoma was fit to the [O2]v-data and the fitted equation was differentiated analytically to obtain the first and second order derivatives. The MVO2 decreased from 94 +/- 5 microliters O2/s/100 g (mean +/- SE) before cardiac arrest to 15.4 +/- 5 microliters O2/s/100 g after 15 s of cardiac arrest. The change in MVO2 (50% in 3.8 +/- 0.3 s) preceded the change in venous oxygen content (50% in 12.7 +/- 0.5 s) and the change in coronary resistance (50% in 14.9 +/- 0.9). These results are in accordance with the hypothesis that interstitial O2 concentration is a major determinant of coronary resistance.

摘要

在从心跳到心脏骤停的转变过程中,已经测量了心肌耗氧量(MVO2)的变化率。通过注射福尔马林破坏希氏束并通过25秒的起搏中断来诱导心脏骤停。在恒压下灌注左冠状动脉主干,并在控制压力下引流心大静脉。连续测量动静脉氧含量差O2以及冠状动脉和静脉血流量(分别为CAF和CVF)。基于三室模型,使用以下方程计算MVO2瞬变:MVO2 = CAF·O2 - (Vc + Vv)·d[O2]v/dt - (Vc·Vv/CVF)·d2[O2]v/dt2,其中Vc和Vv是作为时间函数的毛细血管和静脉血容量,[O2]v是静脉氧含量。对[O2]v数据拟合七阶多项式,并对拟合方程进行解析求导以获得一阶和二阶导数。心脏骤停前MVO2从94±5微升O2/秒/100克(平均值±标准误)降至心脏骤停15秒后的15.4±5微升O2/秒/100克。MVO2的变化(在3.8±0.3秒内变化50%)先于静脉氧含量的变化(在12.7±0.5秒内变化50%)和冠状动脉阻力的变化(在14.9±0.9秒内变化50%)。这些结果符合间质氧浓度是冠状动脉阻力主要决定因素的假设。

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