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通过心肌钾和酸碱平衡评估犬不同手术诱导类型心脏骤停的心肌应激(作者译)

[Myocardial stress of different surgically induced types of cardiac arrest in dogs evaluated by myocardial potassium and acid-base balance (author's transl)].

作者信息

Franz C, Bovenkamp U, Hirche H, Hügel W, Maetzig B, Schumacher E

出版信息

Thoraxchir Vask Chir. 1978 Jun;26(3):194-200. doi: 10.1055/s-0028-1096622.

Abstract

In mongrel dogs myocardial stress of the following types of artificial cardiac arrest in moderate hypothermia and cardiopulmonary bypass was compared: 1. Ischemic arrest after aortic occlusion lasting 30 or 45 minutes. 2. Injection-cardioplegia according to Kirsch lasting 90 minutes. 3. infusion-cardioplegia according to Bretschneider lasting 90 minutes. The following parameters were compared: extracellular potassium activity ([K+]e) during cardiac arrest and [K+] in arterial and coronary venous blood during reflow, total [K+] and acid-base balance during reflow, time course of [K+] and lactic acid release and uptake during reflow after cardiac arrest. In our experimental conditions the lowest alterations of myocardial [K+] and acid-base balance were observed after infusion-cardioplegia according to Bretschneider. Injection-cardioplegia according to Kirsch was less protective for the heart as evidenced by more intensive acidosis, enlarged [K+] loss and prolongation of [K+] uptake during reflow. Ischemic cardiac arrest in moderate hypothermia was the worst type of artificial standstill indicated by development of fatal myocardial acidosis.

摘要

在杂种犬中,比较了中度低温和体外循环下以下几种类型的人工心脏骤停时的心肌应激情况:1. 主动脉阻断后缺血性停搏持续30或45分钟。2. 按照Kirsch法进行的注射式心脏停搏液灌注持续90分钟。3. 按照Bretschneider法进行的灌注式心脏停搏液灌注持续90分钟。比较了以下参数:心脏停搏期间的细胞外钾活性([K+]e)以及再灌注期间动脉血和冠状静脉血中的[K+]、再灌注期间的总[K+]和酸碱平衡、心脏停搏后再灌注期间[K+]和乳酸释放及摄取的时间进程。在我们的实验条件下,按照Bretschneider法进行灌注式心脏停搏液灌注后,心肌[K+]和酸碱平衡的变化最小。按照Kirsch法进行的注射式心脏停搏液灌注对心脏的保护作用较差,这表现为更严重的酸中毒、更大的[K+]丢失以及再灌注期间[K+]摄取的延长。中度低温下的缺血性心脏停搏是最糟糕的人工停跳类型,表现为致命性心肌酸中毒的发生。

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