Ensinger H, Weichel T, Lindner K H, Grünert A, Georgieff M
Universitätsklinik für Anaesthesiologie, Universität Ulm, Germany.
Intensive Care Med. 1995 Jan;21(1):50-6. doi: 10.1007/BF02425154.
To determine whether noradrenaline, adrenaline and dopamine have persistent actions on VO2 and metabolism.
Descriptive laboratory investigation.
Laboratory of the Department of Anaesthesiology at a University Hospital.
9 volunteers.
VO2 and the plasma concentration of glucose and free fatty acids were measured prior to and during a 4 h infusion of saline (control), noradrenaline (0.14 microgram/kg min) adrenaline (0.08 microgram/kg min) or dopamine (7 micrograms/kg min), n = 9 each. VO2 was measured using an open circuit gas exchange system.
VO2 increased from 250 +/- 22 ml/min to 280 +/- 38 ml/min during noradrenaline, to 298 +/- 30 ml/min during adrenaline and to 292 +/- 39 ml/min during dopamine infusion. The plasma glucose concentration increased from 6.2 +/- 0.6 mmol/l to 8.8 +/- 0.8 mmol/l, 13.2 +/- 1.4 and 7.3 +/- 0.4 mmol/l during infusion of noradrenaline, adrenaline or dopamine, respectively. The plasma free fatty acid concentration increased from 0.28 +/- 0.10 mmol/l to 0.79 +/- 0.21 mmol/l during noradrenaline and to 0.52 +/- 0.09 mmol/l during dopamine. In contrast, free fatty acid values averaged baseline values at the end of the adrenaline infusion after an initial increase to 0.72 +/- 0.31 mmol/l.
Administration of noradrenaline, adrenaline or dopamine resulted in persistent increases in VO2 in volunteers. With the exception of the transient adrenaline effect on fatty acids the metabolic actions were steady during 4 h of adrenergic stimulation. Since the adrenergic effect on VO2 is persistent over time a similar action in patients (e.g. septic shock) during treatment with adrenoceptor agonists may be important. Thus, an increase in VO2 during therapy may not only reflect an oxygen debt but also a pharmacodynamic action of adrenoceptor mediated calorigenic and metabolic induction.
确定去甲肾上腺素、肾上腺素和多巴胺对耗氧量（VO2）和代谢是否具有持续作用。
描述性实验室研究。
一所大学医院麻醉科实验室。
9名志愿者。
在输注生理盐水（对照）、去甲肾上腺素（0.14微克/千克·分钟）、肾上腺素（0.08微克/千克·分钟）或多巴胺（7微克/千克·分钟）的4小时期间及之前，测量VO2以及血浆葡萄糖和游离脂肪酸浓度，每组n = 9。使用开路气体交换系统测量VO2。
在输注去甲肾上腺素期间，VO2从250±22毫升/分钟增加到280±38毫升/分钟；在输注肾上腺素期间增加到298±30毫升/分钟；在输注多巴胺期间增加到292±39毫升/分钟。在输注去甲肾上腺素、肾上腺素或多巴胺期间，血浆葡萄糖浓度分别从6.2±0.6毫摩尔/升增加到8.8±0.8毫摩尔/升、13.2±1.4毫摩尔/升和7.3±0.4毫摩尔/升。在输注去甲肾上腺素期间，血浆游离脂肪酸浓度从0.28±0.10毫摩尔/升增加到0.79±0.21毫摩尔/升；在输注多巴胺期间增加到0.52±0.09毫摩尔/升。相比之下，在肾上腺素输注结束时，游离脂肪酸值在最初增加到0.72±0.31毫摩尔/升后平均为基线值。
给予去甲肾上腺素、肾上腺素或多巴胺可使志愿者的VO2持续增加。除了肾上腺素对脂肪酸的短暂作用外，在4小时的肾上腺素能刺激期间代谢作用是稳定的。由于肾上腺素能对VO2的作用随时间持续存在，因此在使用肾上腺素能受体激动剂治疗期间患者（如脓毒性休克）中类似的作用可能很重要。因此，治疗期间VO2的增加可能不仅反映氧债，还反映肾上腺素能受体介导的产热和代谢诱导的药效学作用。
