Gouin F, Faizende J, Martin C, François G
Ann Anesthesiol Fr. 1978;19(10):853-7.
A study of the development of intra-pulmonary shunts was carried out in ten subjects following an intra-venous administration of a 7.5 microgram/kg/min dose of dobutamine by electric syringe. All the subjects were on a respirator (FiO2=0,6 most often) and frequently with P.E.E.P. The shunts were determined at the FiO2 by which the subject was being treated. The cardiac flow was measured by thermodilution. In 9 cases out of 10 the intra-pulmonary shunt is sharply increased already in the first half hour by dobutamine. The shunt values are in the order of: -- 17.94p. 100 +/- 7.19 before the drug -- 26.50 p. 100 +/- 12.85 half an hour after the infusion beginning. The shunt increase is thus 47p. 100 of the average original value after half an hour, which is significant (p less than 0.01). The shunt is then stable at the attained value (hourly average : 26.05 +/- 12.25). These observations are discussed in relation to the obtained effects on the cardiac outout, to the PaO2, and to the quantity of transported arterial oxygen. It appears in this series that, in spite of the shunt increase, there is no risk of cellular oxygen deficiency.
对10名受试者进行了一项关于肺内分流发展的研究，通过电动注射器静脉注射7.5微克/千克/分钟剂量的多巴酚丁胺。所有受试者均使用呼吸机（最常见的FiO2 = 0.6），且经常使用呼气末正压通气（PEEP）。在受试者接受治疗的FiO2水平下测定分流情况。通过热稀释法测量心输出量。10例中有9例在多巴酚丁胺注射后的前半小时内肺内分流即急剧增加。分流值如下：用药前为17.94%±7.19%；输注开始半小时后为26.50%±12.85%。因此，半小时后分流增加量为平均初始值的47%，具有显著性（p＜0.01）。此后分流在达到的水平保持稳定（每小时平均值：26.05±12.25）。结合对心输出量、动脉血氧分压（PaO2）以及输送的动脉氧量的影响对这些观察结果进行了讨论。在该系列研究中发现，尽管分流增加，但不存在细胞缺氧的风险。
