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组胺输注过程中完整犬的肺微血管静水压变化及肺液平衡

Pulmonary hydrostatic microvascular pressure changes and lung fluid balance during histamine infusion in intact dogs.

作者信息

Rodriguez L M, D'Orio V, Dehareng A, Wahlen C, Fossion A, Juchmes J, Marcelle R

出版信息

Circ Shock. 1987;22(1):83-90.

PMID:3608106
Abstract

The effects of histamine on systemic and pulmonary hemodynamics of dogs were studied in six intact animals. Histamine infusion resulted in an almost immediate, precipitous fall in blood pressure (BP), pulmonary capillary wedge pressure (PCWP), and right atrial pressure (RA) as well as an increase in heart rate. Partial recovery occurred about 5 minutes after infusion was stopped. Cardiac output did not change significantly. Consequently, the calculated peripheral resistance decreased afterwards. Hepatic portal pressure rose significantly after 2 minutes of histamine infusion with partial recovery in about 5 minutes. Suprahepatic venous pressure did not change significantly. Although pulmonary arterial pressure did not necessarily rise, total pulmonary vascular resistance increased in every dog. If the absolute level in pulmonary arterial resistance remained greater (Ra 105 mm Hg/liter-1 min X kg-1) than the level of venous resistance (Rv 70 mm Hg/liter-1 min X kg-1), the relative increase in venous resistance (100%) was higher than the increase in Ra (35%). On the other hand, effective capillary pulmonary pressure remained unchanged. Central blood volume and extravascular lung water increased upon histamine infusion and returned rapidly to baseline when histamine infusion was stopped. No significant changes occurred in either effective pulmonary compliance and arterial blood gas values. Our data lead us to conclude that histamine's major action occurs in the venous pulmonary segments; pulmonary and splanchnic blood pooling is responsible for a fall in cardiac preload; and an increase in extravascular lung water and central blood volume with unchanged effective pulmonary pressure might be explained by an increase in microvascular surface area.

摘要

在六只健康犬身上研究了组胺对其全身和肺血流动力学的影响。输注组胺几乎立即导致血压(BP)、肺毛细血管楔压(PCWP)和右心房压(RA)急剧下降,同时心率增加。停止输注后约5分钟出现部分恢复。心输出量无明显变化。因此,随后计算得出的外周阻力降低。输注组胺2分钟后肝门静脉压力显著升高,约5分钟后部分恢复。肝上静脉压力无明显变化。虽然肺动脉压不一定升高,但每只犬的总肺血管阻力均增加。如果肺动脉阻力的绝对值(Ra 105 mmHg/liter-1 min X kg-1)仍高于静脉阻力水平(Rv 70 mmHg/liter-1 min X kg-1),则静脉阻力的相对增加(100%)高于Ra的增加(35%)。另一方面,有效毛细血管肺压保持不变。输注组胺后中心血容量和血管外肺水增加,停止输注组胺后迅速恢复至基线水平。有效肺顺应性和动脉血气值均无明显变化。我们的数据使我们得出结论:组胺的主要作用发生在肺静脉段;肺和内脏血液淤积导致心脏前负荷下降;血管外肺水和中心血容量增加而有效肺压不变可能是由于微血管表面积增加所致。

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