Leeman M, Lejeune P, Mélot C, Deloof T, Naeije R
Department of Intensive Care, Erasme University Hospital, Brussels, Belgium.
Acta Anaesthesiol Scand. 1988 Feb;32(2):147-51. doi: 10.1111/j.1399-6576.1988.tb02704.x.
Methylprednisolone has been reported to impair hypoxic pulmonary vasoconstriction in isolated lungs, possibly by inhibiting the generation of vasoconstricting products of arachidonic acid metabolism. We investigated the effects of methylprednisolone on mean pulmonary artery pressure (PAP):cardiac index (Q) relationships in intact pentobarbital anaesthetized dogs ventilated alternatively in hyperoxia (fraction of inspired O2, FiO2 0.4) and in hypoxia (FiO2 0.1). Cardiac output was increased by opening an arterio-venous femoral fistula or reduced by stepwise inflations of a balloon in the inferior vena cava. Five point PAP:Q relationships were found to be rectilinear in all experimental conditions. Over the entire range of Q studied (2 to 5 l/min.m2), hypoxia increased PAP in seven dogs ("responders") and did not affect PAP in three other dogs ("non-responders"). A hypoxic pulmonary pressor response was restored in these three "non-responders" by administration of 1 g acetylsalicylic acid iv. Methylprednisolone 30 mg/kg iv had no effect on hyperoxic and on hypoxic pulmonary vascular tone in the "responders" and in the "non-responders" treated with acetylsalicylic acid. An additional dog pretreated with methylprednisolone 30 mg/kg iv 24 h before the experiment still had a marked hypoxia-induced increase in PAP over the entire range of Q studied. Thus a large dose of methylprednisolone does not affect hypoxic or hyperoxic pulmonary vascular tone in intact dogs. These data do not support the hypothesis that products of arachidonic acid metabolism mediate hypoxic pulmonary vasoconstriction.
据报道,甲基强的松龙可能通过抑制花生四烯酸代谢产生的血管收缩产物,损害离体肺脏的缺氧性肺血管收缩。我们研究了甲基强的松龙对戊巴比妥麻醉的完整犬在高氧(吸入氧分数,FiO2 0.4)和低氧(FiO2 0.1)交替通气时平均肺动脉压(PAP)与心指数(Q)关系的影响。通过开放股动静脉瘘增加心输出量,或通过逐步向下腔静脉内充气气球减少心输出量。发现在所有实验条件下,五点PAP:Q关系呈直线。在所研究的整个Q范围内(2至5升/分钟·平方米),低氧使7只犬(“反应者”)的PAP升高,而另外3只犬(“无反应者”)的PAP未受影响。静脉注射1克乙酰水杨酸可使这3只“无反应者”恢复缺氧性肺升压反应。静脉注射30毫克/千克甲基强的松龙对“反应者”以及用乙酰水杨酸治疗的“无反应者”的高氧和低氧肺血管张力均无影响。另一只在实验前24小时静脉注射30毫克/千克甲基强的松龙预处理的犬,在所研究的整个Q范围内,低氧仍使PAP显著升高。因此,大剂量甲基强的松龙不影响完整犬的低氧或高氧肺血管张力。这些数据不支持花生四烯酸代谢产物介导缺氧性肺血管收缩这一假说。