Warley A R, Gutierrez G
Department of Internal Medicine, University of Texas Health Science Center, Houston 77030.
J Appl Physiol (1985). 1988 Apr;64(4):1584-90. doi: 10.1152/jappl.1988.64.4.1584.
It has been proposed that an increase in the affinity of hemoglobin for O2 may be beneficial in severe hypoxemia. To test this hypothesis, we compared the response to progressive hypoxemia in dogs with normal hemoglobin affinity (P50 = 32.4 +/- 0.7 Torr) to dogs with a left shift of the oxyhemoglobin dissociation curve (P50 = 21.9 +/- 0.5 Torr) induced by chronic oral administration of sodium cyanate. Animals were anesthetized, paralyzed, and mechanically ventilated. The inspired O2 fraction was progressively lowered by increasing the inspired fraction of N2. The lowest level of O2 transport required to maintain base-line O2 consumption (VO2) was 9.3 +/- 0.8 ml.min-1.kg-1 for control and 16.5 +/- 1.1 ml.min-1.kg-1 for the sodium cyanate-treated dogs (P less than 0.01). Other measured parameters at this level of O2 transport were, for experimental vs. control: arterial PO2 19.3 +/- 2.4 (SE) Torr vs. 21.8 +/- 1.6 Torr (NS); arterial O2 content 10.0 +/- 1.2 ml/dl vs. 4.9 +/- 0.4 ml/dl (P less than 0.01); mixed venous PO2 14.0 +/- 1.5 Torr vs. 13.8 +/- 1.0 Torr (NS); mixed venous O2 content 6.8 +/- 1.0 ml/dl vs. 2.3 +/- 0.2 ml/dl (P less than 0.01); and O2 extraction ratio 32.7 +/- 2.8% vs. 51.2 +/- 3.8% (P less than 0.01). We conclude that chronic administration of sodium cyanate appears to be detrimental to O2 transport, since the experimental dogs were unable to increase their O2 extraction ratios to the same level as control, thus requiring a higher level of O2 transport to maintain their base-line VO2 values.
有人提出,提高血红蛋白对氧气的亲和力可能对严重低氧血症有益。为了验证这一假设,我们比较了正常血红蛋白亲和力(P50 = 32.4±0.7托)的犬与因长期口服氰酸钠导致氧合血红蛋白解离曲线左移(P50 = 21.9±0.5托)的犬对渐进性低氧血症的反应。动物被麻醉、麻痹并进行机械通气。通过增加氮气的吸入比例逐渐降低吸入氧气分数。维持基线氧气消耗(VO2)所需的最低氧气运输水平,对照组为9.3±0.8毫升·分钟-1·千克-1,氰酸钠处理组为16.5±1.1毫升·分钟-1·千克-1(P<0.01)。在这个氧气运输水平下,其他测量参数,实验组与对照组相比:动脉血氧分压19.3±2.4(SE)托对21.8±1.6托(无显著差异);动脉血氧含量10.0±1.2毫升/分升对4.9±0.4毫升/分升(P<0.01);混合静脉血氧分压14.0±1.5托对13.8±1.0托(无显著差异);混合静脉血氧含量6.8±1.0毫升/分升对2.3±0.2毫升/分升(P<0.01);以及氧气提取率32.7±2.8%对51.2±3.8%(P<0.01)。我们得出结论,长期给予氰酸钠似乎对氧气运输有害,因为实验组犬无法将其氧气提取率提高到与对照组相同的水平,因此需要更高水平的氧气运输来维持其基线VO2值。