Woyke Simon, Ronzani Marco, Mair Norbert, Frisch Christoph, Marcher Katharina, Haller Thomas, Ströhle Mathias, Rugg Christopher
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
J Crit Care. 2025 Feb;85:154916. doi: 10.1016/j.jcrc.2024.154916. Epub 2024 Sep 18.
Hemoglobin‑oxygen (Hb-O) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O affinity.
In this experimental ex-vivo trial, venous blood samples were taken from 5 male and 6 female volunteers and incubated with the particular cardiovascular agents. Oxygen dissociation curves (ODC) were measured in-vitro with a new high-throughput method.
Compared to the P in male and female controls, a significant right-shift of the ODC was found for noradrenaline and milrinone in all participants and for levosimendan in male samples only. Adrenaline decreased Hb-O affinity in male samples, atropine in female samples only.
All investigated agents decreased Hb-O affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.
血红蛋白-氧（Hb-O）亲和力是氧输送和氧摄取的重要决定因素。尽管去甲肾上腺素、肾上腺素、阿托品、米力农和左西孟旦等心血管药物在全球重症监护病房中广泛使用，但它们对Hb-O亲和力可能产生的影响却一无所知。
在这项体外实验性试验中，从5名男性和6名女性志愿者身上采集静脉血样本，并与特定的心血管药物一起孵育。采用一种新的高通量方法在体外测量氧解离曲线（ODC）。
与男性和女性对照组的P相比，所有参与者中去甲肾上腺素和米力农以及仅男性样本中的左西孟旦均使ODC出现显著右移。肾上腺素降低男性样本中的Hb-O亲和力，阿托品仅降低女性样本中的Hb-O亲和力。
所有研究药物均降低了Hb-O亲和力，男性和女性之间存在显著差异。尽管潜在机制尚不清楚，但只要维持肺部氧摄取，这些效应的程度可能会增加组织水平的氧摄取。
