van Lambalgen A A, van Kraats A A, Mulder M F, van den Bos G C, Teerlink T, Thijs L G
Laboratory for Physiology, Free University, Amsterdam, The Netherlands.
J Crit Care. 1993 Jun;8(2):117-27. doi: 10.1016/0883-9441(93)90016-e.
Endotoxemia causes a decrease of blood flow to most organs. If this could be prevented, chances of survival might improve. In endotoxemic rats, we studied the effect of a therapeutic infusion of dopexamine (dopaminergic, beta 2-adrenergic) on blood flow and percentage of the cardiac output distributed to heart, brain, hepatic artery, stomach, intestines, spleen, pancreas, kidneys, adrenals, diaphragm, skeletal muscle, and skin. Dopexamine action was compared with that of dobutamine (beta 1-adrenergic). Endotoxin shock was induced in 28 rats with infusion of 8 mg/kg Escherichia coli O127:B8 endotoxin from 0 to 60 minutes; the rats were then divided into 3 groups, which received from 60 to 135 minutes of an infusion of saline (ES; n = 10), dopexamine hydrochloride (DX, 3 x 10(-8) mol/kg.min; n = 10) or dobutamine (DB, 10(-7) mol/kg.min; n = 8). A fourth group served as time-matched controls (C, saline from 0 to 135 minutes; n = 8). In the untreated endotexemic rats, cardiac output decreased and organ blood flow decreased except in the diaphragm, heart, and brain; the percentage of the cardiac output to those organs increased. Dopexamine and dobutamine similarly improved cardiac output in endotoxemic rats. All organs benefitted to the same extent from the increased cardiac output. Therapeutic infusion of dopexamine during endotoxemia did not favor flow to any particular organ; redistribution of cardiac output changed little after administration of dopexamine, and its effects were not significantly different from those of dobutamine.
内毒素血症会导致多数器官的血流减少。如果能够预防这种情况，存活几率可能会提高。在患有内毒素血症的大鼠中，我们研究了治疗性输注多培沙明（多巴胺能、β2肾上腺素能）对血流以及分配至心脏、脑、肝动脉、胃、肠、脾、胰腺、肾、肾上腺、膈肌、骨骼肌和皮肤的心输出量百分比的影响。将多培沙明的作用与多巴酚丁胺（β1肾上腺素能）的作用进行了比较。给28只大鼠在0至60分钟内输注8mg/kg大肠杆菌O127:B8内毒素以诱导内毒素休克；然后将大鼠分为3组，在60至135分钟内分别接受生理盐水输注（ES；n = 10）、盐酸多培沙明（DX，3×10⁻⁸mol/kg·min；n = 10）或多巴酚丁胺（DB，10⁻⁷mol/kg·min；n = 8）。第四组作为时间匹配的对照组（C，在0至135分钟内输注生理盐水；n = 8）。在未经治疗的内毒素血症大鼠中，心输出量下降，除膈肌、心脏和脑外的器官血流减少；这些器官的心输出量百分比增加。多培沙明和多巴酚丁胺同样改善了内毒素血症大鼠的心输出量。所有器官从增加的心输出量中受益程度相同。在内毒素血症期间治疗性输注多培沙明对任何特定器官的血流均无促进作用；多培沙明给药后心输出量的重新分配变化不大，其效果与多巴酚丁胺的效果无显著差异。
