Coetzee A, Holland D, Foëx P, Ryder A, Jones L
Anesth Analg. 1984 Nov;63(11):991-7.
The effect of hypocapnia on global and regional myocardial function and coronary blood flow (CBF) was studied in dogs anesthetized with halothane before and after critical constriction of the left anterior descending (LAD) coronary artery. Coronary blood flow decreased 29% (P less than 0.05) when hypocapnia was induced in dogs with a normal LAD artery. Critical constriction reduced CBF by 42% (P less than 0.05). In the critically constricted LAD artery, hypocapnia did not reduce CBF. During hypocapnia and with a normal LAD artery, oxygen extraction by the myocardium increased 16% (P less than 0.01) and oxygen tension in the coronary sinus was reduced by 19% (P less than 0.001). After critical constriction of the LAD, hypocapnia was associated with an increase in oxygen extraction of 14% (P less than 0.01) and the coronary sinus oxygen tension was reduced by 21% (P less than 0.001). CBF of the left circumflex coronary artery (LC) increased 36% (P less than 0.05) after critical constriction to the LAD when compared with control values of the preconstriction phase. However, LC flow did not change during hypocapnia when critical stenosis had been applied to the LAD artery. Although oxygen supply (product of CBF and arterial oxygen content) to the myocardium was reduced during hypocapnia, regional myocardial function did not change from control values. Regional function was similarly maintained during hypocapnia and critical constriction of the LAD.
在左前降支(LAD)冠状动脉严重狭窄前后,研究了低碳酸血症对用氟烷麻醉的犬的整体和局部心肌功能及冠状动脉血流量(CBF)的影响。在LAD动脉正常的犬中诱导低碳酸血症时,冠状动脉血流量减少29%(P<0.05)。严重狭窄使CBF降低42%(P<0.05)。在严重狭窄的LAD动脉中,低碳酸血症并未降低CBF。在低碳酸血症期间且LAD动脉正常时,心肌的氧摄取增加16%(P<0.01),冠状窦中的氧张力降低19%(P<0.001)。LAD严重狭窄后,低碳酸血症与氧摄取增加14%(P<0.01)相关,冠状窦氧张力降低21%(P<0.001)。与LAD严重狭窄前的对照值相比,左旋冠状动脉(LC)的CBF在LAD严重狭窄后增加36%(P<0.05)。然而,当LAD动脉出现严重狭窄时,低碳酸血症期间LC血流量未发生变化。尽管低碳酸血症期间心肌的氧供应(CBF与动脉血氧含量的乘积)减少,但局部心肌功能与对照值相比并未改变。在低碳酸血症和LAD严重狭窄期间,局部功能同样得以维持。