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未代偿和代偿性代谢性酸中毒对犬膈肌的影响。

Effects of uncompensated and compensated metabolic acidosis on canine diaphragm.

作者信息

Howell S, Fitzgerald R S, Roussos C

出版信息

J Appl Physiol (1985). 1985 Nov;59(5):1376-82. doi: 10.1152/jappl.1985.59.5.1376.

Abstract

We investigated the effects of metabolic acidosis and compensated metabolic acidosis on force of contraction of the diaphragm in anesthetized dogs. Mechanically ventilated animals were prepared with an open thorax. A balloon was positioned beneath the diaphragm to measure transdiaphragmatic pressure (Pdi), and a plaster cast was placed around the abdomen to maintain length and geometry of the diaphragm. The force of contraction was evaluated by measuring Pdi during supramaximal phrenic stimulation at different frequencies and also during spontaneous inspiratory efforts. In 13 dogs with an arterial pH (pHa) of 7.38 and arterial PCO2 (PaCO2) of 36.5 Torr, metabolic acidosis was produced by infusion of HCl until pHa equaled 6.98 and PaCO2 equaled 36.4 Torr. Pdi at all frequencies greater than 10 Hz was significantly reduced (P less than 0.05). The dogs were then hyperventilated until pHa was 7.34 and PaCO2 was 12.8 Torr. Pdi was significantly reduced again at all frequencies (P less than 0.05) except 5 Hz. The percent reduction in Pdi by compensated acidosis was significantly greater at low-frequency stimulation than at high (P less than 0.05). Similar qualitative results were observed during spontaneous inspiratory efforts where Pdi was compared at constant magnitudes of diaphragmatic electromyograms. Twitch characteristics revealed that metabolic acidosis led to a significant shortening of twitch relaxation time (P less than 0.05), and compensated metabolic acidosis added to this effect a significant decrease in twitch amplitude (P less than 0.05).

摘要

我们研究了代谢性酸中毒和代偿性代谢性酸中毒对麻醉犬膈肌收缩力的影响。制备了开胸的机械通气动物。在膈肌下方放置一个气球以测量跨膈压(Pdi),并在腹部周围放置石膏模型以维持膈肌的长度和形态。通过在不同频率的超强膈神经刺激期间以及自主吸气努力期间测量Pdi来评估收缩力。在13只动脉pH(pHa)为7.38且动脉PCO2(PaCO2)为36.5托的犬中,通过输注HCl产生代谢性酸中毒,直至pHa等于6.98且PaCO2等于36.4托。所有大于10 Hz频率下的Pdi均显著降低(P小于0.05)。然后使犬过度通气,直至pHa为7.34且PaCO2为12.8托。除5 Hz外,所有频率下的Pdi再次显著降低(P小于0.05)。在低频刺激下,代偿性酸中毒导致的Pdi降低百分比显著高于高频(P小于0.05)。在将膈肌肌电图恒定幅度下的Pdi进行比较的自主吸气努力期间,观察到了类似的定性结果。单次抽搐特征显示,代谢性酸中毒导致抽搐舒张时间显著缩短(P小于0.05),而代偿性代谢性酸中毒在此基础上使抽搐幅度显著降低(P小于0.05)。

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