Sigurdsson G H, Youssef H
Department of Anaesthesia and Intensive Care, University of Berne, Switzerland.
Acta Anaesthesiol Scand. 1993 May;37(4):396-403. doi: 10.1111/j.1399-6576.1993.tb03736.x.
In an intensive care setting we studied the effects of pentoxifylline on hemodynamics, gas-exchange and platelet sequestration in multiple organs in three groups of sheep exposed to endotoxin shock (n = 7 in each). Group P-E was given pentoxifylline before and group E-P after E. coli endotoxin infusion, while group E received normal saline (controls). The endotoxin infusion caused a three-fold increase in pulmonary artery pressure (PAP) and a significant decrease in mean arterial pressure (25-30%; MAP), respiratory compliance (CT; 60%) and arterial oxygen tension (65-70%; Pao2) in all groups after 30 min. After 4 h MAP had improved significantly in the pretreated animals (group P-E) and arterial pH, Pao2 and CT improved in both pentoxifylline-treated groups compared with the controls. On the other hand, the effects of endotoxin on PAP and cardiac index were not significantly influenced by pentoxifylline treatment. In addition, there was a pronounced platelet sequestration in the lungs and in the liver in groups E and E-P during the 4 h study, but in the pretreated group (group P-E) the changes were significantly less marked (P < 0.01). The wet-to-dry weight ratios of the lungs were significantly lower in both pentoxifylline-treated groups compared with the controls (P < 0.01). It was concluded that pentoxifylline modified the effects of endotoxin on hemodynamics, gas exchange and platelet sequestration in the lungs and liver in sheep when it was given prior to endotoxin. However, when it was given after hemodynamic and respiratory signs of shock had appeared, the effects were more moderate.
在重症监护环境中，我们研究了己酮可可碱对内毒素休克的三组绵羊（每组n = 7）多器官血流动力学、气体交换和血小板滞留的影响。P-E组在大肠杆菌内毒素输注前给予己酮可可碱，E-P组在输注后给予，而E组给予生理盐水（对照组）。输注内毒素后30分钟，所有组的肺动脉压（PAP）增加了两倍，平均动脉压（25 - 30%；MAP）、呼吸顺应性（CT；60%）和动脉血氧分压（65 - 70%；Pao2）显著降低。4小时后，预处理动物（P-E组）的MAP显著改善，与对照组相比，两个己酮可可碱治疗组的动脉pH、Pao2和CT均有所改善。另一方面，己酮可可碱治疗对内毒素对PAP和心脏指数的影响没有显著影响。此外，在4小时的研究中，E组和E-P组的肺和肝脏中有明显的血小板滞留，但预处理组（P-E组）的变化明显较小（P < 0.01）。与对照组相比，两个己酮可可碱治疗组的肺湿重与干重之比均显著降低（P < 0.01）。得出的结论是，在内毒素之前给予己酮可可碱时，它改变了内毒素对绵羊血流动力学、气体交换以及肺和肝脏中血小板滞留的影响。然而，当在休克的血流动力学和呼吸体征出现后给予时，效果较为温和。
