Rudinsky B, Bell A, Hipps R, Meadow W
Department of Pediatrics, University of Chicago, Ill.
Dev Pharmacol Ther. 1993;20(3-4):152-61. doi: 10.1159/000457556.
We determined the contribution of endothelium-derived relaxation factor (EDRF) to vascular tone in the systemic, pulmonary, and cerebral circulations of piglets.
11 piglets were anesthetized and mechanically ventilated. Systemic cardiac output was determined by an electromagnetic flow probe placed on the main pulmonary artery. Cerebral blood flow was assessed by determining unilateral internal carotid artery blood flow (ICBF) using a flow probe placed on the common carotid artery after ligation of the ipsilateral external carotid circulation. Progressive inhibition of EDRF was achieved by continuous infusion of the substituted L-arginine analog N-nitro-L-arginine (NNLA). Hemodynamic observations were compared at 0, 0.1, 1.0, 10, 30, and 80 mg/kg cumulative dose of NNLA.
At all NNLA doses > or = 1 mg/kg, both systemic blood pressure and systemic vascular resistance were elevated. At all NNLA doses > or = 10 mg/kg, systemic cardiac output was reduced. At all NNLA doses > or = 10 mg/kg, pulmonary artery pressure and pulmonary vascular resistance were elevated. Although cerebral vascular resistance was elevated at all NNLA doses > or = 10 mg/kg, ICBF was maintained at or near baseline values up to a dose of 80 mg/kg. At all levels of EDRF inhibition, both the pulmonary and systemic circulations demonstrated approximately equal magnitudes of vasoconstriction. In contrast, at 30 and 80 mg/kg cumulative dose of NNLA, the cerebral circulation was relatively less constricted by NNLA than was the systemic circulation. Systemic VO2 was significantly reduced at 30 mg/kg and 80 mg/kg cumulative NNLA dose, while cerebral VO2 was preserved at both NNLA doses.
EDRF contributes to resting vasodilator tone in the systemic, pulmonary, and cerebral circulations in piglets. Progressive inhibition of EDRF constricts the systemic and pulmonary circulation equally. Inhibition of EDRF does not impair the ability of the brain to vary cerebral vascular resistance in order to redistribute blood flow towards itself during a period of reduced cardiac output.
我们确定了内皮衍生舒张因子(EDRF)对仔猪体循环、肺循环和脑循环血管张力的作用。
11只仔猪麻醉后进行机械通气。通过置于主肺动脉的电磁血流探头测定体循环心输出量。在结扎同侧颈外循环后,使用置于颈总动脉的血流探头测定单侧颈内动脉血流(ICBF)来评估脑血流量。通过持续输注取代的L - 精氨酸类似物N - 硝基 - L - 精氨酸(NNLA)来逐步抑制EDRF。在NNLA累积剂量为0、0.1、1.0、10、30和80mg/kg时比较血流动力学观察结果。
在所有NNLA剂量≥1mg/kg时,体循环血压和体循环血管阻力均升高。在所有NNLA剂量≥10mg/kg时,体循环心输出量降低。在所有NNLA剂量≥10mg/kg时,肺动脉压和肺循环血管阻力升高。尽管在所有NNLA剂量≥10mg/kg时脑血管阻力升高,但在剂量达到80mg/kg之前,ICBF维持在或接近基线值。在EDRF抑制的所有水平上,肺循环和体循环均表现出大致相等程度的血管收缩。相比之下,在NNLA累积剂量为30和80mg/kg时,脑循环受NNLA的收缩作用相对小于体循环。在NNLA累积剂量为30mg/kg和80mg/kg时,体循环VO2显著降低,而在这两个NNLA剂量下脑VO2均得以维持。
EDRF有助于维持仔猪体循环、肺循环和脑循环的静息血管舒张张力。对EDRF的逐步抑制同等程度地收缩体循环和肺循环。在心输出量降低期间,抑制EDRF不会损害大脑改变脑血管阻力以将血流重新分配至自身的能力。