Molloy D W, Lee K Y, Jones D, Penner B, Prewitt R M
Chest. 1985 Sep;88(3):432-5. doi: 10.1378/chest.88.3.432.
The authors investigated acute cardiopulmonary effects of noradrenaline and isoproterenol infusion in a canine model of increased pulmonary vascular resistance (PVR) and decreased cardiac output (CO). In six anesthetized, ventilated dogs, autologous blood clots were injected over approximately two hours to increase right ventricular (RV) afterload and decrease CO. After CO had decreased 40 percent dogs were treated with noradrenaline or isoproterenol in alternate sequence. Both drugs increased stroke volume but only isoproterenol affected CO. Flow increased from 1.3 to 3.0 L X min-1 (p less than .01) with isoproterenol infusion. Corresponding to the increase in CO, RV filling pressure and PVR decreased, from 9 to 5 mm Hg, and from 36 to 16 mm Hg X L-1 X min (p less than .01) respectively. When a moderate decrease in CO complicates an acute increase in PVR, isoproterenol may be an excellent drug to treat the decrease in flow.
作者在犬类肺血管阻力(PVR)增加和心输出量(CO)降低的模型中研究了去甲肾上腺素和异丙肾上腺素输注的急性心肺效应。在六只麻醉、通气的犬中,在大约两小时内注入自体血凝块以增加右心室(RV)后负荷并降低心输出量。在心输出量降低40%后,犬依次接受去甲肾上腺素或异丙肾上腺素治疗。两种药物均增加了每搏输出量,但只有异丙肾上腺素影响心输出量。输注异丙肾上腺素时,血流量从1.3增加至3.0 L×min-1(p<0.01)。与心输出量增加相对应,右心室充盈压和肺血管阻力分别从9降至5 mmHg,以及从36降至16 mmHg×L-1×min(p<0.01)。当心输出量适度降低并发急性肺血管阻力增加时,异丙肾上腺素可能是治疗血流量降低的理想药物。