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胎羊心室对充盈压、动脉压以及宫内通气的反应有所不同。

Fetal lamb ventricles respond differently to filling and arterial pressures and to in utero ventilation.

作者信息

Reller M D, Morton M J, Reid D L, Thornburg K L

机构信息

Department of Pediatrics, Oregon Health Sciences University, Portland 97201.

出版信息

Pediatr Res. 1987 Dec;22(6):621-6. doi: 10.1203/00006450-198712000-00001.

Abstract

Right and left ventricular function were investigated in 12 fetal lambs (127-140 days gestation) instrumented with electromagnetic flow sensors on the ascending aorta and the main pulmonary artery, and with vascular catheters. Nine fetuses were equipped with a postductal aortic occluder and the trachea was cannulated in eight. Control arterial blood values were pH 7.36 +/- 0.02 (SD), PCO2 49.3 +/- 2.3 torr, PO2 18.4 +/- 1.7 torr, and hematocrit 37.3 +/- 4.4%. Biventricular function curves relating stroke volume to mean right and left atrial pressure were generated by rapid withdrawal and reinfusion of fetal blood. Both function curves were composed of steep ascending and plateau limbs that intersected at a breakpoint. Stroke volumes at the breakpoints were 0.94 +/- 0.19 ml.kg-1 and 0.63 +/- 0.15 ml.kg-1 for right and left ventricle, respectively (p less than 0.001). During postductal aortic occlusion, arterial pressure increased by 19.3 +/- 7.9 torr while right ventricular stroke volume decreased by approximately 48% and left ventricular stroke volume decreased by approximately 9%. In utero ventilation increased arterial pressure, heart rate, PO2, and oxygen content. Right atrial pressure increased from 3.9 +/- 1.3 to 5.8 +/- 2.9 torr (p less than 0.05); left atrial pressure from 3.5 +/- 1.5 to 10.0 +/- 4.4 torr (p less than 0.05). Aortic flow nearly doubled (112 +/- 29 to 211 +/- 35 ml.min-1.kg-1) (p less than 0.05), and the left ventricular function curve shifted upward. The right ventricular function curve was shifted downward during ventilation. We conclude that the fetal ventricles differ significantly in their outputs, response to changes in arterial pressure, and to the onset of in utero ventilation.

摘要

对12只妊娠127 - 140天的胎羊进行了左右心室功能研究,这些胎羊在升主动脉和主肺动脉上安装了电磁流量传感器,并放置了血管导管。9只胎儿安装了导管后主动脉阻塞器,8只胎儿的气管进行了插管。对照动脉血值为pH 7.36±0.02(标准差),PCO2 49.3±2.3托,PO2 18.4±1.7托,血细胞比容37.3±4.4%。通过快速抽取和回输胎儿血液生成了将每搏量与平均右心房和左心房压力相关的双心室功能曲线。两条功能曲线均由陡峭上升段和平台段组成,在一个转折点相交。右心室和左心室在转折点的每搏量分别为0.94±0.19 ml.kg-1和0.63±0.15 ml.kg-1(p<0.001)。在导管后主动脉阻塞期间,动脉压升高19.3±7.9托,而右心室每搏量下降约48%,左心室每搏量下降约9%。宫内通气增加了动脉压、心率、PO2和氧含量。右心房压力从3.9±1.3托升至5.8±2.9托(p<0.05);左心房压力从3.5±1.5托升至10.0±4.4托(p<0.05)。主动脉血流量几乎增加了一倍(从112±29至211±35 ml.min-1.kg-1)(p<0.05),左心室功能曲线向上移位。通气期间右心室功能曲线向下移位。我们得出结论,胎儿心室在输出量、对动脉压变化的反应以及对宫内通气开始的反应方面存在显著差异。

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