Brudno D S, Truemper E J, Steinhart C M
Department of Pediatrics, Medical College of Georgia, Augusta 30912.
Am J Med Sci. 1993 Aug;306(2):82-8. doi: 10.1097/00000441-199308000-00003.
This study attempted to determine the correlation between oxygen consumption (VO2), pulmonary-capillary blood flow (QEPC), and oxygen delivery (DO2) by rebreathing and invasive techniques obtained over a range of hemoglobin concentration and cardiac output. Twenty mongrel dogs were instrumented with central arterial and venous catheters to determine DO2 by thermodilution cardiac output and standard formulas. The animals were administered isoproterenol in doses that increased DO2 and subsequently were serially phlebotomized by 30%, 40%, and 50% to decrease DO2. All animals were studied using a rebreathing technique to determine noninvasively VO2, QEPC, and DO2. Sixteen dogs completed the experimental protocol. A correlation analysis was carried out for VO2, QEPC, and DO2 obtained by the rebreathing and invasive methods. Thermodilution cardiac output increased from 3.91 +/- 1.77 L/min at baseline to 8.19 +/- 2.50 L/min during isoproterenol infusion. Hemoglobin varied from 12.21 +/- 1.26 gm% at baseline to 5.21 +/- 1.36 g% at 50% phlebotomy. Over this range of conditions, significant correlations were obtained between rebreathing VO2 and invasive VO2 (r = 0.80, p < 0.0001), rebreathing QEPC and invasive QEPC (r = 0.79, p < 0.0001), and rebreathing DO2 and invasive DO2 (r = 0.82 p < 0.0001). These data demonstrate that the rebreathing technique can be used to monitor oxygen metabolism over wide ranges of DO2.
本研究试图通过在一系列血红蛋白浓度和心输出量范围内采用重复呼吸法和侵入性技术,来确定耗氧量(VO2)、肺毛细血管血流量(QEPC)和氧输送量(DO2)之间的相关性。20只杂种犬通过中心动静脉导管进行监测,以便利用热稀释心输出量和标准公式来测定DO2。给这些动物注射异丙肾上腺素,剂量足以增加DO2,随后依次进行30%、40%和50%的放血,以降低DO2。所有动物均采用重复呼吸技术进行研究,以无创方式测定VO2、QEPC和DO2。16只犬完成了实验方案。对通过重复呼吸法和侵入性方法获得的VO2、QEPC和DO2进行了相关性分析。热稀释心输出量从基线时的3.91±1.77升/分钟增加到异丙肾上腺素输注期间的8.19±2.50升/分钟。血红蛋白从基线时的12.21±1.26克%变化到50%放血时的5.21±1.36克%。在这一条件范围内,重复呼吸法测得的VO2与侵入性方法测得的VO2之间存在显著相关性(r = 0.80,p < 0.0001),重复呼吸法测得的QEPC与侵入性方法测得的QEPC之间存在显著相关性(r = 0.79,p < 0.0001),重复呼吸法测得的DO2与侵入性方法测得的DO2之间存在显著相关性(r = 0.82,p < 0.0001)。这些数据表明,重复呼吸技术可用于在较宽的DO2范围内监测氧代谢。