Donaldson M D, Vesey C J, Bouloux P M, Watson J D, Besser G M, Hinds C J
Anaesthetic Research Laboratory, St. Bartholomew's Hospital, London, United Kingdom.
Circ Shock. 1993 Mar;39(3):169-77.
Changes in plasma catecholamine levels in response to the induction of shock and following treatment with buprenorphine or naloxone were determined in a porcine model of Escherichia coli septicaemia. Thirty animals were anaesthetised with alpha-chloralose and infused with live E. coli over 2 hr. One hour after starting the infusion, cardiac index, mean arterial pressure, and pH had decreased significantly (P < 0.001), and there was a significant increase in mixed venous blood lactate concentrations (P < 0.001). This was associated with significant increases in plasma concentrations of adrenaline and noradrenaline (P < 0.001). There was a strong correlation between the extent of the increase in circulating catecholamines and the severity of shock (as reflected by haemodynamic changes and lactic acidosis) as well as significantly higher peak plasma catecholamine concentrations (P < 0.01) and dramatic terminal increases in circulating catecholamines in nonsurviving animals. Animals were randomly divided into three groups and received either naloxone or buprenorphine or an equivalent volume of normal saline and were monitored for a further 3 hr. Both naloxone and buprenorphine produced significant improvements in cardiac index (P < 0.05) and limited the development of acidosis (P < 0.05). This was not associated with any further increase in plasma catecholamine concentrations; indeed, catecholamine levels tended to decrease in treated animals but continued to increase in controls. In summary, we have shown a correlation between the increase in plasma catecholamines and the severity of shock in this model. In addition, we observed that the beneficial effects of treatment with buprenorphine or naloxone were not accompanied by any further increase in plasma catecholamine concentrations.
在大肠杆菌败血症猪模型中，测定了诱导休克以及用丁丙诺啡或纳洛酮治疗后血浆儿茶酚胺水平的变化。30只动物用α-氯醛糖麻醉，并在2小时内输注活的大肠杆菌。开始输注1小时后，心脏指数、平均动脉压和pH值显著下降（P<0.001），混合静脉血乳酸浓度显著升高（P<0.001）。这与血浆肾上腺素和去甲肾上腺素浓度的显著升高有关（P<0.001）。循环儿茶酚胺增加的程度与休克严重程度（以血流动力学变化和乳酸酸中毒反映）之间存在强相关性，并且在未存活动物中血浆儿茶酚胺峰值浓度显著更高（P<0.01）以及循环儿茶酚胺在末期急剧增加。动物被随机分为三组，分别接受纳洛酮或丁丙诺啡或等量生理盐水，并进一步监测3小时。纳洛酮和丁丙诺啡均使心脏指数有显著改善（P<0.05），并限制了酸中毒的发展（P<0.05）。这与血浆儿茶酚胺浓度的任何进一步升高均无关；实际上，治疗动物的儿茶酚胺水平趋于下降，而对照组则持续升高。总之，我们在该模型中显示了血浆儿茶酚胺增加与休克严重程度之间的相关性。此外，我们观察到丁丙诺啡或纳洛酮治疗的有益效果并未伴随血浆儿茶酚胺浓度的任何进一步升高。
