Louis P T, Yamashita Y, Del Toro J, Michael L H, Contant C F, Goddard-Finegold J
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
Biol Neonate. 1994;66(6):359-66. doi: 10.1159/000244129.
Indomethacin has been shown to reduce cerebral blood flow and cerebral blood flow velocities in newborn infants and animals of various species. To answer the question of whether there may be a compromise of cerebral perfusion in hypotensive infants who have been treated with indomethacin, cerebral blood flow and cerebral vascular resistance were determined in 10 control and 16 indomethacin-treated 1-day-old piglets during (1) steady state conditions; (2) 10 min after the administration of saline or a 0.2-mg/kg dose of indomethacin; (3) 1 h after saline or indomethacin administration, and (4) 10 min after induction of moderate hemorrhagic hypotension. Mean arterial blood pressures increased immediately after the infusion of indomethacin in the experimental group. Cerebral blood flows did not change throughout the study despite hemorrhagic hypotension in controls; cerebral blood flows were significantly decreased 10 min after indomethacin infusion in the experimental animals. However, total and regional cerebral blood flows were not further decreased in the presence of moderate hypotension. Cerebral vascular resistance increased 10 min after indomethacin infusion but returned to steady state 1 h following the indomethacin dose. These results suggest that indomethacin lowers baseline cerebral blood flow, but does not impair cerebrovascular regulatory responses during acute, moderate hemorrhagic hypotension in the newborn piglet.
吲哚美辛已被证明可降低新生婴儿及各类动物的脑血流量和脑血流速度。为回答接受吲哚美辛治疗的低血压婴儿是否可能存在脑灌注受损的问题，我们对10只对照仔猪和16只接受吲哚美辛治疗的1日龄仔猪在以下阶段测定了脑血流量和脑血管阻力：(1) 稳态条件下；(2) 给予生理盐水或0.2 mg/kg剂量吲哚美辛后10分钟；(3) 给予生理盐水或吲哚美辛后1小时；(4) 诱导中度出血性低血压后10分钟。实验组在输注吲哚美辛后平均动脉血压立即升高。尽管对照组出现出血性低血压，但在整个研究过程中脑血流量没有变化；在实验动物中，输注吲哚美辛后10分钟脑血流量显著降低。然而，在中度低血压情况下，全脑和局部脑血流量并未进一步降低。输注吲哚美辛后10分钟脑血管阻力增加，但在给予吲哚美辛剂量1小时后恢复到稳态。这些结果表明，吲哚美辛可降低基线脑血流量，但在新生仔猪急性中度出血性低血压期间不会损害脑血管调节反应。
