Schertel E R, Brourman J D, Kling S M, Schmall L M, Tobias T A, Myerowitz P D
Department of Surgery, Ohio State University, Columbus 43210, USA.
Shock. 1994 Aug;2(2):127-32. doi: 10.1097/00024382-199408000-00008.
Vagotomy alters regional blood flow distribution by interrupting the tonic central inhibitory effect of cardiopulmonary vagal afferent nerves on sympathetic outflow predominantly to the renal, splanchnic, and cutaneous circulations. We hypothesized that the alteration of blood flow distribution by vagotomy would lead to disruption of the oxygen consumption-oxygen delivery relationship (VO2/DO2), increase critical DO2 (DO2Crit), and decrease whole-body oxygen extraction ratio (O2ER). Nineteen chloralose-anesthetized, paralyzed, splenectomized dogs were submitted to either bilateral vagosympathectomy (n = 7), bilateral vagotomy (n = 6), or sham denervation (n = 6) following baseline cardiorespiratory parameter measurement. VO2 was measured by indirect calorimetry and carotid blood flow by ultrasonic flow probe. Incremental hemorrhages (1-5 mL/kg) were performed to determine the VO2/DO2 relationship. Cardiorespiratory parameters were measured after each hemorrhage at steady-state VO2. DO2Crit was derived from the VO2/DO2 relationship using a best-fit regression analysis technique. The average DO2Crit values of the vagotomy (9.1 +/- .54) and vagosympathectomy (11.5 +/- 1.2 mL/min/kg) groups were significantly greater than the control group (7.72 +/- .43). After hemorrhage had been performed to a point that decreased mean arterial pressure to approximately 70 mmHg from baseline values, carotid blood flow in the vagosympathectomy group was significantly greater than the control group. We conclude that vagotomy disrupts the VO2/DO2 relationship. Vagosympathectomy causes a severe disruption of the VO2/DO2 relationship, probably by the combined effect of vagotomy and interruption of sympathetic nervous system control of blood flow to the head and neck.
迷走神经切断术通过中断心肺迷走传入神经对主要供应肾脏、内脏和皮肤循环的交感神经传出的紧张性中枢抑制作用，改变局部血流分布。我们假设迷走神经切断术引起的血流分布改变会导致氧消耗-氧输送关系（VO2/DO2）的破坏，增加临界氧输送（DO2Crit），并降低全身氧摄取率（O2ER）。在测量基线心肺参数后，对19只用氯醛糖麻醉、麻痹、脾切除的狗进行双侧迷走交感神经切断术（n = 7）、双侧迷走神经切断术（n = 6）或假去神经支配（n = 6）。通过间接测热法测量VO2，用超声血流探头测量颈动脉血流量。进行递增性出血（1 - 5 mL/kg）以确定VO2/DO2关系。在每次出血后稳定状态的VO2时测量心肺参数。使用最佳拟合回归分析技术从VO2/DO2关系中得出DO2Crit。迷走神经切断术组（9.1 +/- 0.54）和迷走交感神经切断术组（11.5 +/- 1.2 mL/min/kg）的平均DO2Crit值显著高于对照组（7.72 +/- 0.43）。在出血使平均动脉压从基线值降至约70 mmHg后，迷走交感神经切断术组的颈动脉血流量显著高于对照组。我们得出结论，迷走神经切断术会破坏VO2/DO2关系。迷走交感神经切断术会严重破坏VO2/DO2关系，可能是由于迷走神经切断术以及中断对头部和颈部血流的交感神经系统控制的联合作用。
