Jacobsen J, Hansen O B, Sztuk F, Warberg J, Knigge U, Secher N H
Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Acta Physiol Scand. 1993 Nov;149(3):293-301. doi: 10.1111/j.1748-1716.1993.tb09624.x.
Effects of ileus on cardiovascular and hormonal responses to haemorrhage were evaluated in 10 anaesthetized pigs. Ileus was induced and the bleeding sequence repeated on the following day. Before ileus, a resting heart rate (HR) of 105 (range 83-140) beats min-1 remained unchanged until haemorrhage amounted to 15% of the blood volume. With a blood loss of 28% HR increased to a maximum of 162 (126-245) beats min-1. In contrast, ileus increased HR upon initiation of haemorrhage from a similar resting value to a maximum of 200 (152-250) beats min-1 (P < 0.0005). There were neither statistical differences in mean arterial pressure, cardiac output, central venous pressure, thoracic electrical impedance, pulmonary arterial mean pressure, pulmonary wedge pressure, pulmonary and systemic vascular resistances, nor in plasma concentrations of dopamine, adrenaline, vasopressin and aldosterone during haemorrhage before and after ileus. Plasma noradrenaline increased more with haemorrhage after than before ileus: from 2.8 (1.2-5.0) to 13 (2.3-59.0) vs. 3.0 (1.5-4.2) to 3.6 (2.7-17.5) nmol l-1 (P < 0.005). Also, the pancreatic polypeptide response to haemorrhage was enlarged with ileus (29 (0-60) to 90 (45-145) vs. 23 (0-64) to 57 (27-106) pmol l-1 (P < 0.005)). No significant differences could be detected in cardiovascular and hormonal responses to haemorrhage before and after a sham-operation in three pigs. Results demonstrate an immediate and enhanced HR response to haemorrhage in the pig with ileus, reflected in sympathetic activation as indicated by plasma noradrenaline.
在10只麻醉猪身上评估了肠梗阻对出血时心血管和激素反应的影响。诱导产生肠梗阻,并在次日重复出血过程。在肠梗阻前,静息心率(HR)为105(范围83 - 140)次/分钟,直到出血量达到血容量的15%时保持不变。失血28%时,HR增加到最高162(126 - 245)次/分钟。相比之下,肠梗阻使出血开始时的HR从类似的静息值增加到最高200(152 - 250)次/分钟(P < 0.0005)。在肠梗阻前后出血期间,平均动脉压、心输出量、中心静脉压、胸电阻抗、肺动脉平均压、肺楔压、肺血管和体循环血管阻力以及血浆多巴胺、肾上腺素、血管加压素和醛固酮浓度均无统计学差异。肠梗阻后出血时血浆去甲肾上腺素的增加幅度大于肠梗阻前:从2.8(1.2 - 5.0)到13(2.3 - 59.0)对比从3.0(1.5 - 4.2)到3.6(2.7 - 17.5)nmol/L(P < 0.005)。此外,肠梗阻使出血时的胰多肽反应增强(从29(0 - 60)到90(45 - 145)对比从23(0 - 64)到57(27 - 106)pmol/L(P < 0.005))。三只假手术猪在假手术前后对出血的心血管和激素反应未检测到显著差异。结果表明,肠梗阻猪对出血有即时且增强的HR反应,如血浆去甲肾上腺素所示,反映为交感神经激活。