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使用全人工心脏的动物的氧代谢

Oxygen metabolism in animals with total artificial hearts.

作者信息

Chiang B Y, Pantalos G M, Burns G L, Long J W, Khanwilkar P S, Everett S D, Mohammad S F, Olsen D B

机构信息

Artificial Heart Research Laboratory, University of Utah, Salt Lake City 84103-1414, USA.

出版信息

ASAIO J. 1994 Jul-Sep;40(3):M510-3. doi: 10.1097/00002480-199407000-00052.

Abstract

The relationship between indices of oxygen metabolism has been widely used in clinical practice to evaluate the adequacy of tissue perfusion, to predict the outcome of the critically ill patient, and to evaluate the effectiveness of therapies. This study quantitated and correlated the relationship between oxygen delivery (DO2), oxygen consumption (VO2), and oxygen extraction rate (EO2) in 14 animals with total artificial hearts (TAH) to investigate the oxygen metabolism in animals with TAH during different physiologic and pathologic conditions. These 14 animals were subdivided into healthy, critical, and exercise groups. There was a physiologic dependence of DO2 to VO2 in animals in the healthy and exercise groups, whereas a pathologic dependence of VO2 to DO2 appeared to occur in animals in the critical group. Reduced or inadequate VO2 leads to organ dysfunction, shock syndrome, multiple organ failure, and finally, mortality. Providing a higher level of DO2 by restoring circulating blood volume, increasing cardiac output, raising hematocrit levels, and improving pulmonary function to achieve a higher level of oxygen extract efficiency and oxygen consumption in animals with TAH that are in a critical condition might be helpful for the treatment of complications and result in decreasing mortality. Using the relationship between indices of oxygen metabolism as a physiologic modifier for TAH control algorithms also might improve the physiologic performance and quality of life of TAH recipients.

摘要

氧代谢指标之间的关系已在临床实践中广泛用于评估组织灌注是否充足、预测危重病患者的预后以及评估治疗效果。本研究对14只植入全人工心脏(TAH)的动物的氧输送(DO2)、氧消耗(VO2)和氧摄取率(EO2)之间的关系进行了量化和相关性分析,以研究TAH动物在不同生理和病理状态下的氧代谢情况。这14只动物被分为健康组、危重组和运动组。在健康组和运动组动物中,DO2对VO2存在生理依赖性,而在危重组动物中似乎出现了VO2对DO2的病理依赖性。VO2降低或不足会导致器官功能障碍、休克综合征、多器官衰竭,最终导致死亡。对于处于危急状态的TAH动物,通过恢复循环血容量、增加心输出量、提高血细胞比容水平和改善肺功能来提供更高水平的DO2,以实现更高水平的氧提取效率和氧消耗,可能有助于治疗并发症并降低死亡率。将氧代谢指标之间的关系用作TAH控制算法的生理调节剂,也可能改善TAH接受者的生理性能和生活质量。

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