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急性内毒素血症期间的肝脏阴离子通量。

Hepatic anion flux during acute endotoxemia.

作者信息

Kellum J A, Bellomo R, Kramer D J, Pinsky M R

机构信息

Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh Medical Center, Pennsylvania 15213-2582, USA.

出版信息

J Appl Physiol (1985). 1995 Jun;78(6):2212-7. doi: 10.1152/jappl.1995.78.6.2212.

Abstract

We sought to determine the role the liver might play in the regulation of anion-cation balance during both stable baseline conditions and acute endotoxemia. Ten pentobarbital sodium-anesthetized dogs were instrumented at laparotomy with ultrasonic flow probes around the left renal artery, portal vein, and hepatic artery, and catheters were inserted into the hepatic vein, portal vein, pulmonary artery, left renal vein, and abdominal aorta. Measurements were obtained from each site at baseline and 30-45 min after the intravenous infusion of endotoxin. The total anion flux across the liver was calculated from the strong-ion difference. At baseline, the liver removed anions from the circulation (-0.34 meq/min). With early endotoxemia, however, the liver switched to the release of anions (0.12 meq/min; P = 0.0046). After endotoxin administration, the gut, which was neutral at baseline, began to take up anions (-0.47 meq/min; P = 0.008). Anion flux across the lung and kidney was unchanged. We conclude that in the dog the liver, which removes anions at baseline, switches to release anions during early endotoxemia and may be a major site of acid production in early sepsis.

摘要

我们试图确定肝脏在稳定的基线条件和急性内毒素血症期间对阴阳离子平衡调节中可能发挥的作用。十只戊巴比妥钠麻醉的犬在剖腹手术时,于左肾动脉、门静脉和肝动脉周围安装超声流量探头,并将导管插入肝静脉、门静脉、肺动脉、左肾静脉和腹主动脉。在基线时以及静脉输注内毒素后30 - 45分钟从每个部位进行测量。通过强离子差计算肝脏总的阴离子通量。在基线时,肝脏从循环中清除阴离子(-0.34毫当量/分钟)。然而,在早期内毒素血症时,肝脏转变为释放阴离子(0.12毫当量/分钟;P = 0.0046)。给予内毒素后,在基线时呈中性的肠道开始摄取阴离子(-0.47毫当量/分钟;P = 0.008)。通过肺和肾的阴离子通量未改变。我们得出结论,在犬中,基线时清除阴离子的肝脏在早期内毒素血症期间转变为释放阴离子,并且可能是早期脓毒症中酸产生的主要部位。

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