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酸碱输注后两种形式的循环停滞性缺氧期间的氧气运输。

O2 transport during two forms of stagnant hypoxia following acid and base infusions.

作者信息

Cain S M, Adams R P

出版信息

J Appl Physiol Respir Environ Exerc Physiol. 1983 Jun;54(6):1518-24. doi: 10.1152/jappl.1983.54.6.1518.

Abstract

Cardiac output and mean arterial pressure were decreased in two groups of 16 anesthetized paralyzed dogs ventilated by pump. Pericardial tamponade was used in one group, and hemorrhagic hypotension was used in the other. After a 30-min control period and 30 min of circulatory shock by either method, 0.3N HCl was infused into half the dogs in each group and 1.0N NaHCO3 into the other half so that pH was separated by 0.3-0.4 units. The slope of the line relating O2 uptake to total O2 transport (blood flow X arterial O2 concentration) was used to evaluate how well the tissues extracted O2 relative to O2 supply. During the initial shock period before infusion, the slope of the line relating O2 uptake of left hindlimb skeletal muscle to total O2 transport in the limb was almost twice as great as that for the whole body. Acid infusion increased the slope of the whole-body line but did not alter that for the hindlimb. Base infusion, on the other hand, decreased the slope of the line for the limb during hemorrhagic shock but had no other effect. We concluded that acid either improved the distribution of a limiting blood supply to nonmuscle organ systems, or increased tissue capillary PO2 and O2 diffusion by decreasing hemoglobin O2 affinity (HOA), or both. The effect of an increased HOA with base infusion was noticeable in hindlimb skeletal muscle only when volume depletion by hemorrhage presumably greatly increased the normally short intercapillary diffusion distance in muscle.

摘要

在两组由泵通气的16只麻醉瘫痪犬中,心输出量和平均动脉压均降低。一组采用心包填塞,另一组采用失血性低血压。在30分钟的对照期和通过任何一种方法进行30分钟的循环休克后,每组一半的犬输注0.3N盐酸,另一半输注1.0N碳酸氢钠,以使pH值相差0.3 - 0.4个单位。用氧气摄取量与总氧气运输量(血流量×动脉血氧浓度)的关系曲线斜率来评估组织相对于氧气供应摄取氧气的情况。在输注前的初始休克期,左后肢骨骼肌的氧气摄取量与肢体总氧气运输量的关系曲线斜率几乎是全身曲线斜率的两倍。输注酸增加了全身曲线的斜率,但未改变后肢曲线的斜率。另一方面,在失血性休克期间,输注碱降低了后肢曲线的斜率,但没有其他影响。我们得出结论,酸要么改善了有限血液供应向非肌肉器官系统的分布,要么通过降低血红蛋白氧亲和力(HOA)增加了组织毛细血管氧分压和氧气扩散,或者两者兼而有之。仅当出血导致的容量耗竭可能极大地缩短了肌肉中正常较短的毛细血管间扩散距离时,输注碱导致的HOA增加才在后肢骨骼肌中明显可见。

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