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硝普钠控制性低血压期间犬的中心和内脏血流动力学

Central and splanchnic haemodynamics in the dog during controlled hypotension with sodium nitroprusside.

作者信息

Lagerkranser M, Andreen M, Irestedt L

出版信息

Acta Anaesthesiol Scand. 1984 Feb;28(1):81-6. doi: 10.1111/j.1399-6576.1984.tb02016.x.

Abstract

The effects of controlled hypotension induced by sodium nitroprusside (SNP) on central and splanchnic haemodynamics were studied in ten artificially ventilated dogs under neurolept anaesthesia. SNP was given intravenously as a continuous infusion in order to maintain a mean arterial blood pressure (MABP) of about 50 mmHg. Observations were made before (control) and at 20 and 60 min after the start of the SNP infusion. The mean SNP dosage was 13.7 micrograms X kg-1 X min-1. Systemic vascular resistance (SVR) decreased by 47%. After 20 min there was a 17% decrease in cardiac output, while the hepatic arterial blood flow was diminished by 39%, and portal venous blood flow by 16%. Cardiac output and portal venous blood flow tended to return towards control values at 60 min, while the hepatic arterial blood flow remained depressed. The total oxygen uptake was unaltered after 20 min, but slightly decreased after 60 min. There were no changes in hepatic or preportal tissue oxygen consumption, nor in hepatic lactate uptake. It is concluded that SNP-induced hypotension was achieved primarily by a profound reduction of SVR, and initially also by a slight decrease in cardiac output. Although splanchnic and hepatic blood flows decreased, there were no signs of hypoxia in the preportal tissues or in the liver.

摘要

在十只接受神经安定麻醉并人工通气的狗身上,研究了硝普钠(SNP)诱导的控制性低血压对中枢和内脏血流动力学的影响。静脉持续输注SNP以维持平均动脉血压(MABP)约为50 mmHg。在SNP输注开始前(对照)以及输注开始后20分钟和60分钟进行观察。SNP的平均剂量为13.7微克·千克⁻¹·分钟⁻¹。全身血管阻力(SVR)降低了47%。20分钟后心输出量下降了17%,而肝动脉血流量减少了39%,门静脉血流量减少了16%。60分钟时心输出量和门静脉血流量趋于恢复到对照值,而肝动脉血流量仍处于较低水平。20分钟后总氧摄取量未改变,但60分钟后略有下降。肝组织或门静脉前组织的氧消耗以及肝脏对乳酸的摄取均无变化。结论是,SNP诱导的低血压主要是通过SVR的显著降低实现的,最初也伴有心输出量的轻微下降。虽然内脏和肝脏血流量减少,但门静脉前组织或肝脏中没有缺氧迹象。

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