Lee R W, Lancaster L D, Gay R G, Paquin M, Goldman S
Department of Internal Medicine, Tucson Veterans Administration Medical Center, Arizona 85723.
Am J Physiol. 1988 Jan;254(1 Pt 2):H115-9. doi: 10.1152/ajpheart.1988.254.1.H115.
To define total vascular capacitance, we used acetylcholine to arrest the heart and measured mean circulatory filling pressure (MCFP) during controlled hemorrhage and volume loading in 12 splenectomized dogs after ganglion blockade with hexamethonium. We also examined the gross pathological and histological changes in the lungs. Controlled hemorrhage (n = 12) of 5 and 10 ml/kg decreased MCFP from 6.8 +/- 0.1 to 4.9 +/- 0.3 and 3.6 +/- 0.2 mmHg, respectively. Volume loading of 5 (n = 8) and 10 ml/kg (n = 4) increased MCFP to 9.3 +/- 0.2 and 12.1 +/- 0.1 mmHg, respectively. At MCFPs below 5 mmHg, the pressure (P)-volume (V) relationship was not linear [(P = P0ekV, where k is slope of ln (MCFP) vs. V, k = 0.061, R2 = 0.998]. At MCFPs between 5 and 12 mmHg, the pressure-volume relationship was linear (slope = 0.479 mmHg.ml-1.kg-1, R2 = 0.992) and total vascular compliance was 2.09 ml.mmHg-1.kg-1. There were no changes in heart rate, cardiac output, right atrial, pulmonary artery, and pulmonary artery wedge pressures when values at base line were compared with those measured 15 min after each arrest. There were no changes in arterial gas measurements or acid-base balance, and there was no evidence of atelectasis or interstitial or intra-alveolar edema. We conclude that the total body pressure-volume relationship in the presence of ganglion blockade had a nonlinear configuration. The use of acetylcholine to arrest the heart, four times with hexamethonium in reflex-blocked animals, did not result in changes in hemodynamics or pulmonary function.
为了定义总血管容量,我们使用乙酰胆碱使心脏停搏,并在六甲铵进行神经节阻滞后,对12只脾切除犬在控制性出血和容量负荷过程中测量平均循环充盈压(MCFP)。我们还检查了肺部的大体病理和组织学变化。5 ml/kg和10 ml/kg的控制性出血(n = 12)分别使MCFP从6.8±0.1 mmHg降至4.9±0.3 mmHg和3.6±0.2 mmHg。5 ml/kg(n = 8)和10 ml/kg(n = 4)的容量负荷分别使MCFP升高至9.3±0.2 mmHg和12.1±0.1 mmHg。在MCFP低于5 mmHg时,压力(P)-容量(V)关系呈非线性[(P = P0ekV,其中k是ln(MCFP)与V的斜率,k = 0.061,R2 = 0.998]。在MCFP为5至12 mmHg之间时,压力-容量关系呈线性(斜率 = 0.479 mmHg·ml-1·kg-1,R2 = 0.992),总血管顺应性为2.09 ml·mmHg-1·kg-1。将基线值与每次心脏停搏后15分钟测量的值进行比较时,心率、心输出量、右心房、肺动脉和肺动脉楔压均无变化。动脉血气测量或酸碱平衡无变化,也没有肺不张或间质或肺泡内水肿的证据。我们得出结论,在神经节阻滞情况下,全身压力-容量关系呈非线性构型。在反射性阻断的动物中使用乙酰胆碱使心脏停搏四次(联合六甲铵),并未导致血流动力学或肺功能改变。