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急性等容血液稀释期间对多巴酚丁胺的血流动力学反应。

Hemodynamic responses to dobutamine during acute normovolemic hemodilution.

作者信息

Shinoda T, Mekhail N A, Estafanous F G, Smith C, Khairallah P A

机构信息

Division of Anesthesiology, Cleveland Clinic Foundation, OH 44195.

出版信息

J Cardiothorac Vasc Anesth. 1994 Oct;8(5):545-51. doi: 10.1016/1053-0770(94)90167-8.

Abstract

The effects of dobutamine (DOB) on myocardial performance, systemic hemodynamics, and oxygen delivery during acute normovolemic hemodilution in anesthetized rats were studied. Forty-two Sprague Dawley rats (body weight 375 to 425 g) were divided into six equal groups. Hemodynamic and cardiac indices were measured or calculated at baseline, 30 minutes after the initiation of hemodilution (HD), and 15 minutes after DOB or saline infusion. Myocardial performance in response to acute pressure or volume loads was studied in all groups of animals. HD to a hematocrit (Hct) value of 20% resulted in no change in heart rate (HR), increased CI, SVI, and LV dP/dt, and decreased MAP, SVRI, and oxygen delivery index (O2DI). HD increased peak SV and CI after preload stress while the left ventricular developed pressure (LVDP) was unchanged. Infusion of DOB as 7.5 or 15 micrograms/kg/min increased HR, CI, and LV dP/dt as well as LVDP. At the same time, DOB decreased MAP and SVR, whereas the SVI remained unchanged. In non-HD animals both doses of DOB increased LVDP, but only the larger dose increased CI, whereas peak SV decreased with the smaller dose. Arterial carbon dioxide tension (PaCO2) increased, whereas pH and arterial oxygen tension (PaO2) decreased; however, O2DI remained unchanged. Concomitant hemodilution and DOB infusion resulted in attenuation of HR response to DOB, exaggerated the drop in MAP and SVR, and increased LV dP/dt. Only the larger dose of DOB increased the CI, whereas neither dose could alter the SVI in HD animals.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

研究了多巴酚丁胺(DOB)对麻醉大鼠急性等容血液稀释期间心肌功能、全身血流动力学和氧输送的影响。将42只斯普拉格-道利大鼠(体重375至425克)分为6个相等的组。在基线、血液稀释(HD)开始后30分钟以及DOB或生理盐水输注后15分钟测量或计算血流动力学和心脏指数。在所有动物组中研究了对急性压力或容量负荷的心肌反应。将血细胞比容(Hct)值稀释至20%导致心率(HR)无变化,心脏指数(CI)、每搏量指数(SVI)和左心室dp/dt增加,平均动脉压(MAP)、全身血管阻力指数(SVRI)和氧输送指数(O2DI)降低。预负荷应激后,HD增加了峰值每搏量和CI,而左心室舒张末压(LVDP)未改变。以7.5或15微克/千克/分钟的剂量输注DOB可增加HR、CI和LV dp/dt以及LVDP。同时,DOB降低了MAP和SVR,而SVI保持不变。在非HD动物中,两种剂量的DOB均增加了LVDP,但只有较大剂量增加了CI,而较小剂量时峰值每搏量降低。动脉二氧化碳分压(PaCO2)升高,而pH值和动脉血氧分压(PaO2)降低;然而,O2DI保持不变。同时进行血液稀释和DOB输注导致对DOB的HR反应减弱,MAP和SVR下降加剧,并增加了LV dp/dt。只有较大剂量的DOB增加了CI,而两种剂量均不能改变HD动物的SVI。(摘要截断于250字)

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