Berman W, Lister G, Alverson D, Olsen S
Pediatr Res. 1987 May;21(5):447-52. doi: 10.1203/00006450-198705000-00005.
We studied the effects of anemia and ouabain administration on cardiac function, oxygen physiology, and blood catecholamine levels in nine newborn lambs. We measured oxygen consumption continuously, along with traditional hemodynamic variables. Oxygen transport was calculated. Following baseline measurements, lambs were made anemic (mean hematocrit = 12%) by isovolemic exchange transfusion with Plasmanate, and measurements were repeated. Thereafter ouabain was administered as a 75 micrograms/kg bolus, followed by 30 min of infusion at a rate of 0.05 microgram/kg/min. Measurements were repeated at the conclusion of infusion. Anemia was associated with a heart rate related rise in left ventricular rate of pressure rise, a rise in oxygen consumption, an increase in cardiac output, a decrease in systemic vascular resistance, and a rise in fractional oxygen extraction (oxygen consumption/transport). Following ouabain administration, cardiac output, oxygen consumption, and stroke work fell, but left ventricular rate of pressure rise and the extraction ratio did not change. Serum levels of epinephrine and norepinephrine rose with sustained anemia and ouabain infusion. In this setting, ouabain effects are manifested primarily by alterations in oxygen transport and metabolism rather than by changes in traditional assessments of left ventricular contractile function.
我们研究了贫血和给予哇巴因对9只新生羔羊心脏功能、氧生理学和血儿茶酚胺水平的影响。我们持续测量耗氧量以及传统的血流动力学变量,并计算氧输送量。在进行基线测量后,通过用血浆蛋白溶液进行等容交换输血使羔羊贫血(平均血细胞比容 = 12%),然后重复测量。此后,以75微克/千克的剂量推注哇巴因,随后以0.05微克/千克/分钟的速率输注30分钟。在输注结束时重复测量。贫血与左心室压力上升速率随心率升高、耗氧量增加、心输出量增加、全身血管阻力降低以及氧提取分数(耗氧量/输送量)升高有关。给予哇巴因后,心输出量、耗氧量和每搏功下降,但左心室压力上升速率和提取率未改变。随着持续性贫血和哇巴因输注,血清肾上腺素和去甲肾上腺素水平升高。在这种情况下,哇巴因的作用主要表现为氧输送和代谢的改变,而非传统评估的左心室收缩功能的变化。