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巴比妥酸盐疗法对大鼠缺血后脑氧合的影响

Postischemic brain oxygenation with barbiturate therapy in rats.

作者信息

Nemoto E M, Frinak S, Taylor F

出版信息

Crit Care Med. 1979 Aug;7(8):339-45. doi: 10.1097/00003246-197908000-00004.

Abstract

We measured rat brain cortex PO2 (PtO2) with gold microelectrodes (tip diameter 5--10 micron) for up to 2 hours after 16 min of transient global brain ischemia with and without thiopental 90 mg/kg infused iv over 60 min beginning at 5 min postischemia. Seventeen rats were immobilized and mechanically ventilated on 1% halothane in oxygen with continuous monitoring of PtO2, ECG, end-expiratory CO2, rectal temperature, and arterial blood pressure. Global ischemia was induced by trimethaphan hypotension to an MAP of about 50 torr and a neck tourniquet inflated to 1500 torr. Postischemia, nine control rats (11 PtO2 measurements) were untreated and eight rats (8 PtO2 measurements) received thiopental 90 mg/kg. Preischemia, PtO2 values in both groups ranged from less than 5--70 torr with values of greatest frequency between 10 and 15 torr. Postischemia, PtO2 in control rats peaked at 45 +/- 8 (SEM) torr at 20 min. In thiopental treated rats, peak PtO2 was 24 +/- 6 torr at 10 min postischemia. Relative frequency histograms of PtO2 revealed that PtO2 in thiopental treated rats was lower (p less than 0.05) between 15 and 30 min postischemia. The magnitude of the decrease in PtO2 between 105 and 120 min postischemia appeared to correlate directly with the absolute preischemic value (i.e., the higher the preischemic PtO2, the greater the decrease in PtO2 postischemia). These results suggest that thiopental administered in large doses in early postischemia does not improve brain oxygenation secondary to a reduction in brain oxygen consumption. The relevance of the correlation between the magnitude of the fall in PtO2 postischemia and the magnitude of the preischemic value is discussed.

摘要

我们使用金微电极(尖端直径5 - 10微米)测量大鼠脑皮质的氧分压(PtO2),在短暂性全脑缺血16分钟后持续测量2小时,缺血后5分钟开始静脉输注硫喷妥钠90毫克/千克,输注时间60分钟,实验分为有硫喷妥钠组和无硫喷妥钠组。17只大鼠被固定并在1%的氟烷和氧气中进行机械通气,同时持续监测PtO2、心电图、呼气末二氧化碳、直肠温度和动脉血压。通过三甲噻方使血压降低至平均动脉压约50托,并使用颈部止血带充气至1500托来诱导全脑缺血。缺血后,9只对照大鼠(进行11次PtO2测量)未接受治疗,8只大鼠(进行8次PtO2测量)接受硫喷妥钠90毫克/千克治疗。缺血前,两组的PtO2值范围为小于5 - 70托,最频繁出现的值在10 - 15托之间。缺血后,对照大鼠的PtO2在20分钟时达到峰值45±8(标准误)托。在硫喷妥钠治疗的大鼠中,缺血后10分钟时PtO2峰值为24±6托。PtO2的相对频率直方图显示,硫喷妥钠治疗的大鼠在缺血后15至30分钟之间PtO2较低(p小于0.05)。缺血后105至120分钟之间PtO2下降的幅度似乎与缺血前的绝对值直接相关(即缺血前PtO2越高,缺血后PtO2下降越大)。这些结果表明,在缺血后早期大剂量给予硫喷妥钠并不能因降低脑氧消耗而改善脑氧合。本文讨论了缺血后PtO2下降幅度与缺血前值幅度之间相关性的意义。

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