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呼吸性酸中毒和碱中毒时输注碳酸氢钠对犬脑血流量的影响

Influence on cerebral blood flow of infusion of sodium bicarbonate during respiratory acidosis and alkalosis in the dog.

作者信息

Arvidsson S, Häggendal E, Winsö I

出版信息

Acta Anaesthesiol Scand. 1981 Apr;25(2):146-52. doi: 10.1111/j.1399-6576.1981.tb01625.x.

Abstract

In anaesthetized dogs, a mixed acid-base disturbance was induced by adding a pronounced metabolic alkaline to an established respiratory acidosis or alkalosis. Cerebral blood flow (CBF) was measured by the radioisotope washout method. In the hypocapnic dogs, the addition of metabolic alkalosis did not significantly change cerebral blood flow. In the hypercapnic dogs, the intravenous infusion of alkali led to a substantial reduction of cerebral blood flow, parallelled by a reduction of cerebrovenous oxygen tension. Acid-base analysis of cerebrospinal fluid (CSF) indicated an increased bicarbonate concentration. Hypercapnia is suggested to facilitate the passage of bicarbonate over the blood-brain barrier, leading to cerebral vasoconstriction by means of increased extravascular pH.

摘要

在麻醉犬中,通过在已建立的呼吸性酸中毒或碱中毒基础上添加明显的代谢性碱来诱发混合性酸碱紊乱。采用放射性同位素洗脱法测量脑血流量(CBF)。在低碳酸血症犬中,添加代谢性碱并未显著改变脑血流量。在高碳酸血症犬中,静脉输注碱导致脑血流量大幅减少,同时脑静脉血氧张力降低。脑脊液(CSF)的酸碱分析表明碳酸氢盐浓度升高。提示高碳酸血症促进碳酸氢盐通过血脑屏障,通过增加血管外pH值导致脑血管收缩。

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