Tateyama T, Asada M, Suzuki H, Hashimoto K, Nose H, Okazaki K, Okutsu Y
Department of Anesthesiology, Yokohama City University School of Medicine.
Masui. 1995 Jul;44(7):932-6.
We investigated the effects of increased arterial carbon dioxide (PaCO2 not equal to 60 mmHg) on myocardial tissue oxygen tension and metabolism in anesthetized dogs. Ten adult mongrel dogs weighing 15.3 +/- 4.1 kg were anesthetized with 0.5% isoflurane in 50% oxygen and ventilated mechanically to maintain normocapnia. After thoracotomy, regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode inserted in the myocardium. Electromagnetic blood flow probes were applied on the left anterior descending artery and the circumflex artery. A 23-gauge catheter was inserted into a coronary vein to obtain coronary venous blood for measuring oxygen content, lactate and pyruvate. After control normocapnic ventilation, hypercapnia (PaCO2 62.7 +/- 3.2 mmHg) was induced by adding 10% carbon dioxide to the inspired gas for 20 minutes. As a result, the coronary blood flow and myocardial oxygen tension increased during hypercapnia. The myocardial lactate extraction and coronary venous lactate were unchanged and excess lactate was kept below zero, although coronary venous L/P ratio increased during hypercapnia. These results indicate that hypercapnia (PaCO2 not equal to 60 mmHg) increases coronary blood flow and myocardial oxygen tension, while myocardial aerobic metabolism is not impaired under hypercapnia.
我们研究了动脉血二氧化碳分压升高(PaCO2不等于60 mmHg)对麻醉犬心肌组织氧张力和代谢的影响。选用10只体重为15.3±4.1 kg的成年杂种犬,用含50%氧气的0.5%异氟烷麻醉,并进行机械通气以维持正常碳酸血症。开胸后,使用插入心肌的单极极谱针电极测量局部心肌组织的PO2。将电磁血流探头置于左前降支动脉和回旋支动脉上。将一根23号导管插入冠状静脉以获取冠状静脉血,用于测量氧含量、乳酸和丙酮酸。在控制正常碳酸血症通气后,通过向吸入气体中添加10%二氧化碳20分钟来诱导高碳酸血症(PaCO2 62.7±3.2 mmHg)。结果,高碳酸血症期间冠状动脉血流量和心肌氧张力增加。心肌乳酸摄取和冠状静脉乳酸水平未发生变化,尽管高碳酸血症期间冠状静脉L/P比值升高,但过量乳酸仍保持在零以下。这些结果表明,高碳酸血症(PaCO2不等于60 mmHg)可增加冠状动脉血流量和心肌氧张力,而高碳酸血症下心肌有氧代谢未受损害。