Hine I P, Wood W G, Mainwaring-Burton R W, Butler M J, Irving M H, Booker B
Br J Anaesth. 1976 Apr;48(4):355-63. doi: 10.1093/bja/48.4.355.
Plasma and urinary catecholamine concentrations have been measured in 13 patients undergoing cardiac surgery involving cardiopulmonary bypass. The large and progressive increase in plasma catecholamines during bypass reported in previous studies has not been confirmed, and this may be a result of improvements in surgical, anaesthetic and perfusion techniques. The interpretation of urinary findings was complicated by the finding of a positive correlation between catecholamine excretion and urine flow-rate. The findings suggest the need to modify current concepts of the adrenergic response to cardiac surgery and bypass, and question the validity of measuring the urinary catecholamine concentration as an index of stress in these circumstances.
对13例接受体外循环心脏手术的患者测定了血浆和尿儿茶酚胺浓度。先前研究报道的体外循环期间血浆儿茶酚胺大量且持续增加的情况未得到证实，这可能是手术、麻醉和灌注技术改进的结果。儿茶酚胺排泄与尿流率之间呈正相关，这一发现使对尿液检测结果的解读变得复杂。这些发现表明需要修正目前关于心脏手术和体外循环时肾上腺素能反应的概念，并质疑在这些情况下将尿儿茶酚胺浓度作为应激指标测量的有效性。
