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慢性贫血期间氟烷麻醉的血流动力学后果。

Hemodynamic consequences of halothane anesthesia during chronic anemia.

作者信息

Barrera M, Miletich D J, Albrecht R F, Hoffman W E

出版信息

Anesthesiology. 1984 Jul;61(1):36-42.

PMID:6430129
Abstract

The hemodynamic effects of halothane anesthesia in chronically anemic mongrel dogs were evaluated. Control and anemic animals (13.7 +/- 0.4 g/dl hemoglobin mean +/- SE vs. 3.4 +/- 0.3 g/dl) were exposed to 0.75, 1.5, and 2.25% inspired halothane and changes in cardiac output (CO), heart rate (HR), dp/dt, heart work, heart efficiency, myocardial oxygen consumption (MVO2), mean arterial blood pressure (MABP), central venous pressure (CVP), left ventricular end-diastolic pressure (LVDP), left coronary blood flow (CBF), systemic vascular resistance (SVR), and myocardial lactate metabolism were measured and compared. Anemic dogs showed a significantly lower SVR at each halothane dose when compared with controls. In addition, SVR progressively decreased with increasing halothane in anemic dogs, while SVR remained unchanged in controls. CO, CBF, MVO2, and heart work all were significantly greater in anemic canines compared with controls with each halothane concentration. Heart efficiency, dp/dt, HR, and MABP were not significantly different in anemic and control dogs. Neither control nor anemic dogs demonstrated myocardial hypoxia as evidenced by a lack of myocardial lactate production. The results from this study suggest that anemic animals appear to tolerate large concentrations of halothane.

摘要

评估了氟烷麻醉对慢性贫血杂种犬的血流动力学影响。将对照动物和贫血动物(血红蛋白均值±标准误分别为13.7±0.4g/dl和3.4±0.3g/dl)暴露于0.75%、1.5%和2.25%的吸入氟烷中,测量并比较心输出量(CO)、心率(HR)、dp/dt、心脏作功、心脏效率、心肌耗氧量(MVO2)、平均动脉血压(MABP)、中心静脉压(CVP)、左心室舒张末期压力(LVDP)、左冠状动脉血流量(CBF)、全身血管阻力(SVR)和心肌乳酸代谢的变化。与对照相比,贫血犬在每个氟烷剂量下的SVR均显著降低。此外,贫血犬的SVR随氟烷浓度增加而逐渐降低,而对照犬的SVR保持不变。在每个氟烷浓度下,贫血犬的CO、CBF、MVO2和心脏作功均显著高于对照犬。贫血犬和对照犬的心脏效率、dp/dt、HR和MABP无显著差异。对照犬和贫血犬均未出现心肌乳酸生成,表明未出现心肌缺氧。本研究结果表明,贫血动物似乎能耐受高浓度的氟烷。

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