Coetzee A, Kotzé J, Louw J, Lochner A
J Thorac Cardiovasc Surg. 1986 Feb;91(2):259-69.
The use of an oxygenated crystalloid cardioplegic solution to improve myocardial preservation during elective cardiac arrest was evaluated with the isolated perfused rat heart used as a model. Experiments were conducted at 4 degrees C and 20 degrees C. The oxygen tension of the nonoxygenated and oxygenated cardioplegic solutions averaged 117 and 440 mm Hg, respectively. At 4 degrees C, the adenosine triphosphate content of hearts subjected to 120 minutes of oxygenated cardioplegia was significantly higher than that of the nonoxygenated cardioplegia group. However, functional recovery during reperfusion was similar for both groups. At 20 degrees C, the myocardial adenosine triphosphate concentration decreased at a significantly faster rate during ischemia in the group receiving nonoxygenated cardioplegia compared with the oxygenated cardioplegia group. Hearts subjected to 180 minutes of ischemia with oxygenated cardioplegia had a normal ultrastructural appearance whereas hearts subjected to 120 minutes of nonoxygenated cardioplegia showed severe ischemic damage. Myocardial functional recovery in the group receiving oxygenated cardioplegia exceeded that of the group receiving nonoxygenated cardioplegia. The use of myocardial adenosine triphosphate concentration at the end of the ischemic period to predict subsequent cardiac output, peak systolic pressure, and total myocardial work showed significant positive correlations.
以离体灌注大鼠心脏为模型，评估了使用含氧晶体心脏停搏液在择期心脏停搏期间改善心肌保护的效果。实验在4℃和20℃下进行。未含氧和含氧心脏停搏液的氧分压平均分别为117和440mmHg。在4℃时，接受120分钟含氧心脏停搏的心脏的三磷酸腺苷含量显著高于未含氧心脏停搏组。然而，两组在再灌注期间的功能恢复相似。在20℃时，与含氧心脏停搏组相比，接受未含氧心脏停搏的组在缺血期间心肌三磷酸腺苷浓度下降速度明显更快。接受180分钟含氧心脏停搏的心脏超微结构外观正常，而接受120分钟未含氧心脏停搏的心脏显示出严重的缺血损伤。接受含氧心脏停搏的组的心肌功能恢复超过了接受未含氧心脏停搏的组。在缺血期末使用心肌三磷酸腺苷浓度来预测随后的心输出量、收缩压峰值和总心肌功显示出显著的正相关。
