Bartelds B, van Bel F, Teitel D F, Rudolph A M
Department of Pediatrics, University of California, San Francisco 94143-0544.
Pediatr Res. 1993 Jul;34(1):51-5. doi: 10.1203/00006450-199307000-00013.
The fetal cardiovascular response to acute hypoxemia consists of a decrease in heart rate, a variable change in mean arterial pressure, and an increase in peripheral vascular resistance. This response is mediated by the arterial chemoreceptors. To determine whether chemoreceptors in the carotid artery or in the aorta mediate the fetal cardiovascular response to acute hypoxemia, we studied the response to acute hypoxemia in fetal lambs at 125 to 130 d of gestation after selective carotid (six fetuses) or aortic (five fetuses) denervation. One to 3 d after insertion of catheters, hypoxemia was induced by inflating a balloon occluder around the ewe's hypogastric artery or by giving the ewe 95% N2 and 5% O2 to breathe. The chemoreflex response was measured as decrease in heart rate per decrease in Hb O2 saturation. To validate our results, we also studied the response to chemical stimulation of the chemoreceptors by injection of sodium cyanide into the inferior vena cava. We found that carotid denervation abolished the heart rate and peripheral vascular resistance responses to hypoxemia but that aortic denervation did not. Responses after injection of sodium cyanide were similar to those seen during acute hypoxemia. We conclude that the carotid chemoreceptors, and not the aortic chemoreceptors, mediate the fetal cardiovascular response to acute hypoxemia.
胎儿对急性低氧血症的心血管反应包括心率下降、平均动脉压的可变变化以及外周血管阻力增加。这种反应由动脉化学感受器介导。为了确定颈动脉或主动脉中的化学感受器是否介导胎儿对急性低氧血症的心血管反应,我们研究了妊娠125至130天的胎羊在选择性颈动脉(6只胎儿)或主动脉(5只胎儿)去神经支配后对急性低氧血症的反应。插入导管后1至3天,通过在母羊腹下动脉周围充气气囊阻塞器或让母羊吸入95%氮气和5%氧气来诱导低氧血症。化学反射反应以每降低血红蛋白氧饱和度时的心率下降来衡量。为了验证我们的结果,我们还研究了通过向下腔静脉注射氰化钠对化学感受器进行化学刺激后的反应。我们发现,颈动脉去神经支配消除了对低氧血症的心率和外周血管阻力反应,但主动脉去神经支配没有。注射氰化钠后的反应与急性低氧血症期间观察到的反应相似。我们得出结论,介导胎儿对急性低氧血症心血管反应的是颈动脉化学感受器,而非主动脉化学感受器。