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介导心率对低氧血症反应的机制。

Mechanisms mediating the heart rate response to hypoxemia.

作者信息

Kato H, Menon A S, Slutsky A S

机构信息

Department of Medicine, Mount Sinai Hospital Research Institute, University of Toronto, Ontario, Canada.

出版信息

Circulation. 1988 Feb;77(2):407-14. doi: 10.1161/01.cir.77.2.407.

Abstract

We studied the effect of phasic pulmonary afferent information on heart rate (HR) during a progressive reduction in oxygen saturation (SaO2). The Hering-Breuer reflex was evaluated with the use of the ratio of apnea duration after lung inflation to the preceding expiratory time (dT). Phasic afferent activity was stopped in anesthetized, paralyzed dogs by constant-flow ventilation (CFV), a technique that removes cyclic changes in lung volume. During normocapnic (PaCO2 = 36.4 +/- 1.1 mm Hg) spontaneous breathing, there was a wide variability in HR response, with a mean delta HR/delta SaO2 (+/- SE) of 0.62 +/- 0.27 beats/min/% (values greater than 0 indicate a tachycardiac response). There was a good correlation between delta HR/delta SaO2 and dT (r = .79). Mean delta HR/delta SaO2 for the combined normocapnic and hypercapnic studies during CFV was lower (-1.32 +/- 0.19 bpm/%) than that during spontaneous breathing (0.23 +/- 0.19, p less than .0001). We suggest that the HR response to hypoxemia is strongly related to the strength of the Hering-Breuer reflex, which may explain the large interdog variability in HR responses.

摘要

我们研究了在氧饱和度(SaO2)逐渐降低的过程中,阶段性肺传入信息对心率(HR)的影响。通过肺充气后呼吸暂停持续时间与前一次呼气时间的比值(dT)来评估黑林-布雷尔反射。在麻醉、麻痹的犬中,通过恒流通气(CFV)停止阶段性传入活动,CFV是一种消除肺容积周期性变化的技术。在正常碳酸血症(PaCO2 = 36.4 +/- 1.1 mmHg)的自主呼吸过程中,心率反应存在很大差异,平均心率变化/氧饱和度变化(+/-标准误)为0.62 +/- 0.27次/分钟/%(大于0的值表示心动过速反应)。心率变化/氧饱和度变化与dT之间存在良好的相关性(r = 0.79)。在CFV期间,正常碳酸血症和高碳酸血症联合研究的平均心率变化/氧饱和度变化(-1.32 +/- 0.19次/分钟/%)低于自主呼吸期间(0.23 +/- 0.19,p < 0.0001)。我们认为,对低氧血症的心率反应与黑林-布雷尔反射的强度密切相关,这可能解释了犬之间心率反应的巨大差异。

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