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氟烷对猪(Sus scrofa)心脏功能和代谢的剂量依赖性抑制作用。

Dose-dependent depression of cardiac function and metabolism by halothane in swine (Sus scrofa).

作者信息

Merin R G, Verdouw P D, de Jong J W

出版信息

Anesthesiology. 1977 Jun;46(6):417-23. doi: 10.1097/00000542-197706000-00008.

Abstract

Halothane depresses myocardial blood flow and metabolism in the dog, but no studies in man have been published. However, the coronary circulation of the pig is remarkably similar to that of man. The authors investigated the effects of halothane-nitrous oxide anesthesia on cardiac function and metabolism in piglets. Thermodilution cardiac output, catheter-tip-manometer measurement of left ventricular function, electro-magnetic flowmeter measurement of coronary blood flow, and blood and tissue measurements of gases and metabolites were made during 0.04 (control), 0.46 (low concentration), and 1.04 (high concentration) per cent halothane vaporized in nitrous oxide, 60 per cent: oxygen, 40 per cent. Compared with control, the low concentration decreased cardiac output (CO) by 10 per cent, left ventricular systolic pressure (LVSP) by 30 per cent, peak contractile element velocity (Vmax by 34 percent, coronary blood flow (CBF) by 36 per cent, and cardiac oxygen uptake (V02) by 55 per cent. Compared with control, the high concentration decreased CO by 32 per cent, LVSP and Vmax by 53 per cent, CBF by 63 per cent and V02 by 62 per cent. This indicates that the dose-related depression in left ventricular function produced by halothane was accompanied by equivalent decreases in coronary blood flow and oxygen comsumption. There was minimal evidence of anaerobic metabolism in these depressed ventricles. Tissue levels of the high-energy phosplates, adenosinetriphosphate and creatine phosphate, and glycogen were unchanged. It is concluded that changes in cardiac oxygenation and metabolism in the pig during halothane anesthesia result from the changes in ventricular function.

摘要

氟烷可降低犬的心肌血流量和代谢,但尚未有关于人类的研究发表。然而,猪的冠状动脉循环与人的极为相似。作者研究了氟烷 - 氧化亚氮麻醉对仔猪心脏功能和代谢的影响。在氧化亚氮(60%)和氧气(40%)中分别蒸发0.04%(对照)、0.46%(低浓度)和1.04%(高浓度)的氟烷时,进行了热稀释法心输出量、导管尖端压力计测量左心室功能、电磁流量计测量冠状动脉血流量以及血液和组织气体及代谢产物的测量。与对照相比,低浓度使心输出量(CO)降低10%,左心室收缩压(LVSP)降低30%,峰值收缩元件速度(Vmax)降低34%,冠状动脉血流量(CBF)降低36%,心脏氧摄取量(V02)降低55%。与对照相比,高浓度使CO降低32%,LVSP和Vmax降低53%,CBF降低63%,V02降低62%。这表明氟烷引起的左心室功能与剂量相关的抑制伴随着冠状动脉血流量和氧消耗的同等程度降低。在这些功能受抑制的心室中,无氧代谢的证据极少。高能磷酸化合物、三磷酸腺苷和磷酸肌酸以及糖原的组织水平未发生变化。得出的结论是,氟烷麻醉期间猪心脏氧合和代谢的变化是由心室功能的变化引起的。

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